Provider Demographics
NPI:1922170232
Name:TORRES, LORA HOLLIFIELD (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LORA
Middle Name:HOLLIFIELD
Last Name:TORRES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:LORA
Other - Middle Name:REBECCA
Other - Last Name:HOLLIFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:175 THORNBURY DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-8464
Mailing Address - Country:US
Mailing Address - Phone:407-973-0539
Mailing Address - Fax:
Practice Address - Street 1:601 W MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-6203
Practice Address - Country:US
Practice Address - Phone:407-317-7430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT6750225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL812178800Medicaid
FL883877100Medicaid