MEDICARE: DR. ANTHONY JOSEPH LORELLI O.D.

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	152W00000X	Optometrist	OPC2592	FL

General Provider Information

NPI Number	:	1578565800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY JOSEPH LORELLI O.D.

Provider Business Mailing Address
First Line	:	825 WESTWIND DR
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4251
Country	:	US
Telephone Number	:	561-625-6135
Fax Number	:

Provider Business Practice Location Address
First Line	:	3180 NORTHLAKE BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33403-1802
Country	:	US
Telephone Number	:	561-844-2119
Fax Number	:	561-844-6802

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	07/09/2007

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