Healthcare Provider Details

I. General information

NPI: 1477794741
Provider Name (Legal Business Name): LORI MARIE HILL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI MARIE VICTOR ARNP

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7017 CENTRAL AVE
ST PETERSBURG FL
33710
US

IV. Provider business mailing address

3001 EXECUTIVE DR STE 130
CLEARWATER FL
33762-5323
US

V. Phone/Fax

Practice location:
  • Phone: 727-384-2016
  • Fax: 727-343-3791
Mailing address:
  • Phone: 727-347-0005
  • Fax: 727-541-6558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP 9247287
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: