=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023257128
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MOIRA LORING OT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2009
-----------------------------------------------------
Last Update Date | 07/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 410 10TH AVE W
-----------------------------------------------------
City | PALMETTO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34221-5032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-722-3582
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7739 110TH AVE E
-----------------------------------------------------
City | PARRISH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34219-2769
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-441-5553
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 17699
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------