Healthcare Provider Details

I. General information

NPI: 1215864988
Provider Name (Legal Business Name): LORI NEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S PINELLAS AVE
TARPON SPRINGS FL
34689-1955
US

IV. Provider business mailing address

1907 LEAFLAND AVE
DUNEDIN FL
34698-5515
US

V. Phone/Fax

Practice location:
  • Phone: 727-547-3692
  • Fax:
Mailing address:
  • Phone: 804-892-8141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: