Provider Demographics
NPI:1316010697
Name:BEUCLER, LORI A (ARNP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:A
Last Name:BEUCLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:BRANSCOMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12470 TELECOM DR STE 300W
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0904
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7420 SR 54
Practice Address - Street 2:
Practice Address - City:NPR
Practice Address - State:FL
Practice Address - Zip Code:34653
Practice Address - Country:US
Practice Address - Phone:727-484-3981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3298092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP72827Medicare UPIN