Provider Demographics
NPI:1003686007
Name:EXANTUS, LORDINE (ARNP)
Entity Type:Individual
Prefix:
First Name:LORDINE
Middle Name:
Last Name:EXANTUS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 WEDGEWOOD LKS S
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3081
Mailing Address - Country:US
Mailing Address - Phone:561-667-9990
Mailing Address - Fax:
Practice Address - Street 1:106 WEDGEWOOD LKS S
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3081
Practice Address - Country:US
Practice Address - Phone:561-667-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029926363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner