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General NPI Number Information
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NPI Number | 1972451300
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Entity Type | Individual
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Provider Name | LORELLE MARIE SANTIAGO JORDAN
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Gender | Female
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Dates
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Enumeration Date | 03/20/2026
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 1530 CELEBRATION BLVD STE 200
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City | CELEBRATION
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State | FL
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Zip | 34747-5165
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Country | US
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Telephone | 407-934-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 16720 BRONN RD APT 207
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City | WINTER GARDEN
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State | FL
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Zip | 34787-8659
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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 | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State | FL
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