Provider Demographics
NPI:1578565800
Name:LORELLI, ANTHONY JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:LORELLI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 WESTWIND DR
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-4251
Mailing Address - Country:US
Mailing Address - Phone:561-625-6135
Mailing Address - Fax:
Practice Address - Street 1:3180 NORTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33403-1802
Practice Address - Country:US
Practice Address - Phone:561-844-2119
Practice Address - Fax:561-844-6802
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2592152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20417Medicare PIN
FLU45793Medicare UPIN