Provider Demographics
NPI:1235408071
Name:ALESI, LORI LYNN (PTA)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:LYNN
Last Name:ALESI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5393 JUSTINE WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-7553
Mailing Address - Country:US
Mailing Address - Phone:407-310-1767
Mailing Address - Fax:
Practice Address - Street 1:10395 NARCOOSSEE RD
Practice Address - Street 2:SUITE E
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6939
Practice Address - Country:US
Practice Address - Phone:407-730-3244
Practice Address - Fax:407-730-3246
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA23002225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant