MEDICARE: LENORA ADJUDER

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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1427308691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LENORA ADJUDER

Provider Business Mailing Address
First Line	:	654 SW KAYAK AVE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-6426
Country	:	US
Telephone Number	:	772-834-9478
Fax Number	:

Provider Business Practice Location Address
First Line	:	654 SW KAYAK AVE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-6426
Country	:	US
Telephone Number	:	772-834-9478
Fax Number	:

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

Provider Enumeration Date	:	09/14/2012
Last Update Date	:	03/15/2026

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Directions to “ LENORA ADJUDER ” Practice Location

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