Provider Demographics
NPI:1629122502
Name:REID, LORNA K (ARNP)
Entity Type:Individual
Prefix:MS
First Name:LORNA
Middle Name:K
Last Name:REID
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 N STATE ROAD 7
Mailing Address - Street 2:SUITE 190
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5600
Mailing Address - Country:US
Mailing Address - Phone:954-486-1127
Mailing Address - Fax:954-486-4042
Practice Address - Street 1:3500 N STATE ROAD 7
Practice Address - Street 2:SUITE 190
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5600
Practice Address - Country:US
Practice Address - Phone:954-486-1127
Practice Address - Fax:954-486-4042
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2591082363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY7858XMedicare ID - Type UnspecifiedARNP