MEDICARE: LORI S. TOLSON CRNA

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	367500000X	Certified Registered Nurse Anesthetist	RN9234754	FL
2	367500000X	Certified Registered Nurse Anesthetist	APRN9234754	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790044956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI S. TOLSON CRNA

Provider Business Mailing Address
First Line	:	9500 S DADELAND BLVD STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-2866
Country	:	US
Telephone Number	:	305-468-4185
Fax Number	:	305-675-3378

Provider Business Practice Location Address
First Line	:	11011 SHERIDAN ST STE 106
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33026-1501
Country	:	US
Telephone Number	:	954-435-0101
Fax Number	:

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

Provider Enumeration Date	:	05/09/2012
Last Update Date	:	05/21/2021

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Directions to “ LORI S. TOLSON CRNA” Practice Location

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