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General NPI Number Information
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NPI Number | 1346358025
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Entity Type | Individual
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Provider Name | LORI R RAYNOR O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6618 W ATLANTIC AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33446-1616
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Country | US
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Telephone | 561-498-5007
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Fax | 561-496-3088
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Provider Business Mailing Address
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Address Line | 5911 NW 60 AVENUE
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City | PARKLAND
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State | FL
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Zip | 33067
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Country | US
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Telephone | 954-345-4123
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC2253
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License Number State | FL
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