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General NPI Number Information
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NPI Number | 1306692835
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Entity Type | Individual
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Provider Name | LORRAINE ESTES PTA
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Gender | Female
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 1826 N CRYSTAL LAKE DR
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City | LAKELAND
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State | FL
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Zip | 33801-5905
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Country | US
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Telephone | 813-876-8771
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Fax | 813-333-5414
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Provider Business Mailing Address
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Address Line | 146 DELANCEY DR
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City | DAVENPORT
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State | FL
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Zip | 33837-7622
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Country | US
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Telephone | 440-785-5784
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PTA33255
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License Number State | FL
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