Provider Demographics
NPI:1093889529
Name:LOMAS, JERILEE EMMA (DO)
Entity Type:Individual
Prefix:DR
First Name:JERILEE
Middle Name:EMMA
Last Name:LOMAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 BUSINESS WAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-6073
Mailing Address - Country:US
Mailing Address - Phone:239-303-2600
Mailing Address - Fax:239-303-2604
Practice Address - Street 1:1220 BUSINESS WAY
Practice Address - Street 2:SUITE 2
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936
Practice Address - Country:US
Practice Address - Phone:239-303-2600
Practice Address - Fax:239-303-2604
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7648207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL44255WMedicare PIN
FLG34479Medicare UPIN