Provider Demographics
NPI:1326419151
Name:VARGAS, LORA LEE (BS)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:LEE
Last Name:VARGAS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:LEE
Other - Last Name:VARGAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:9440 EMILY LOOP #203
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817
Mailing Address - Country:US
Mailing Address - Phone:407-860-8148
Mailing Address - Fax:
Practice Address - Street 1:9440 EMILY LOOP #203
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817
Practice Address - Country:US
Practice Address - Phone:407-860-8148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker