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General NPI Number Information
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NPI Number | 1528326907
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Entity Type | Individual
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Provider Name | REBEKAH MARIE LOVELESS PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 719 RODEL CV STE 1015
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City | LAKE MARY
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State | FL
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Zip | 32746-5716
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Country | US
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Telephone | 407-262-5800
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Fax | 407-636-7840
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Provider Business Mailing Address
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Address Line | 719 RODEL CV STE 1015
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City | LAKE MARY
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State | FL
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Zip | 32746-5716
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Country | US
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Telephone | 407-262-5800
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Fax | 407-636-7840
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 006370
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9115142
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9115142
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License Number State | FL
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