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General NPI Number Information
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NPI Number | 1609982545
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Entity Type | Individual
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Provider Name | LORNETTE DEMERIA PATRICK ARNPC
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1611 NW 12TH AVENUE JACKSON MEDICAL CENTER
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City | MIAMI
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State | FL
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Zip | 33136
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Country | US
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Telephone | 305-385-5495
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Fax | 305-585-3955
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Provider Business Mailing Address
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Address Line | 15500 SW 106 AVENUE
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City | MIAMI
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State | FL
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Zip | 33157
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Country | US
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Telephone | 305-255-8027
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Fax | 305-255-8027
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1123032
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License Number State | FL
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