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General NPI Number Information
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NPI Number | 1003877796
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Entity Type | Individual
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Provider Name | LOURDES LORINO O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 528 INDIAN BOUNDARY RD
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City | CHESTERTON
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State | IN
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Zip | 46304-1515
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Country | US
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Telephone | 219-250-2470
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Fax | 219-728-1134
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Provider Business Mailing Address
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Address Line | 11420 BROADWAY
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City | CROWN POINT
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State | IN
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Zip | 46307-7106
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Country | US
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Telephone | 219-662-0066
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Fax | 219-662-0055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18002818A
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License Number State | IN
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