Provider Demographics
NPI:1447238969
Name:LORI MCAULIFFE, M.D., P.A.
Entity Type:Organization
Organization Name:LORI MCAULIFFE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCAULIFFE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-345-2212
Mailing Address - Street 1:405 PASADENA AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-2101
Mailing Address - Country:US
Mailing Address - Phone:727-345-2212
Mailing Address - Fax:727-381-3444
Practice Address - Street 1:405 PASADENA AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-2101
Practice Address - Country:US
Practice Address - Phone:727-345-2212
Practice Address - Fax:727-381-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0065127208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00845OtherBLUECROSS