MEDICARE: LIANNIS ACOSTA LORES BSN,RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	9658036	FL

General Provider Information

NPI Number	:	1245172139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIANNIS ACOSTA LORES BSN,RN

Provider Business Mailing Address
First Line	:	1283 PIN OAK DR
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-1500
Country	:	US
Telephone Number	:	321-802-0272
Fax Number	:

Provider Business Practice Location Address
First Line	:	1283 PIN OAK DR
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-1500
Country	:	US
Telephone Number	:	321-802-0272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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