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General NPI Number Information
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NPI Number | 1265202063
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Entity Type | Individual
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Provider Name | ANN-ISABELLE DE LORETTA
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Gender | Female
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Dates
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Enumeration Date | 01/03/2024
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 6030 STRAWBERRY LAKES CIR
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City | LAKE WORTH
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State | FL
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Zip | 33463-6509
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Country | US
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Telephone | 561-714-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 6030 STRAWBERRY LAKES CIR
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City | LAKE WORTH
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State | FL
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Zip | 33463-6509
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Country | US
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Telephone |
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11030410
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License Number State | FL
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