Provider Demographics
NPI:1033442249
Name:STILES, LORI CHRISTINA (LMT)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:CHRISTINA
Last Name:STILES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 SAND PINE CIR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-4504
Mailing Address - Country:US
Mailing Address - Phone:407-314-5644
Mailing Address - Fax:
Practice Address - Street 1:133 SAND PINE CIRCLE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-4504
Practice Address - Country:US
Practice Address - Phone:407-314-5644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA39960172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker