Provider Demographics
NPI:1194008102
Name:ABINSAY, LORI LEE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:LEE
Last Name:ABINSAY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:LEE
Other - Last Name:LIVESAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:4901 GATE PKWY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-4405
Mailing Address - Country:US
Mailing Address - Phone:904-997-7002
Mailing Address - Fax:
Practice Address - Street 1:4901 GATE PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-4405
Practice Address - Country:US
Practice Address - Phone:904-997-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0029536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist