Healthcare Provider Details
I. General information
NPI: 1306760640
Provider Name (Legal Business Name): LORIA MOBILE MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11404 SCARLET TANAGER DR
CHARLOTTE NC
28278-6935
US
IV. Provider business mailing address
11404 SCARLET TANAGER DR
CHARLOTTE NC
28278-6935
US
V. Phone/Fax
- Phone: 631-241-5022
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FRANK
LORIA
Title or Position: OWNER
Credential: FNP
Phone: 631-241-5022