Provider Demographics
NPI:1851324057
Name:DIOLA, LORNA (RPT)
Entity Type:Individual
Prefix:MRS
First Name:LORNA
Middle Name:
Last Name:DIOLA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4923 AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-6332
Mailing Address - Country:US
Mailing Address - Phone:727-526-4134
Mailing Address - Fax:727-362-0084
Practice Address - Street 1:7500 4TH ST N STE A
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5410
Practice Address - Country:US
Practice Address - Phone:727-526-4134
Practice Address - Fax:727-362-0084
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 9222225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8889961Medicaid
FLU0292ZMedicare ID - Type UnspecifiedMEDICARE INDIVIDUAL NO.