Healthcare Provider Details

I. General information

NPI: 1861749533
Provider Name (Legal Business Name): LORILEE K SANTIAGO-PLATO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LORILEE HARTIGAN ARNP

II. Dates (important events)

Enumeration Date: 08/13/2012
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S PINELLAS AVE STE G
TARPON SPGS FL
34689-1950
US

IV. Provider business mailing address

1395 S PINELLAS AVE
TARPON SPRINGS FL
34689-3790
US

V. Phone/Fax

Practice location:
  • Phone: 727-943-3405
  • Fax: 727-937-2269
Mailing address:
  • Phone: 727-942-5054
  • Fax: 727-942-5160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9211789
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: