Provider Demographics
NPI:1619033461
Name:LEBARNES, LORI (PT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:LEBARNES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12402 MAIDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-2866
Mailing Address - Country:US
Mailing Address - Phone:813-343-5500
Mailing Address - Fax:813-343-5506
Practice Address - Street 1:12625 RACE TRACK RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1331
Practice Address - Country:US
Practice Address - Phone:813-343-5500
Practice Address - Fax:813-343-5506
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21058174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist