Provider Demographics
NPI:1942541032
Name:LORIE, PATRICIA (OTR)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:LORIE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11823 SW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2505
Mailing Address - Country:US
Mailing Address - Phone:786-413-6838
Mailing Address - Fax:
Practice Address - Street 1:12060 SW 129TH CT
Practice Address - Street 2:SUITE 107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4581
Practice Address - Country:US
Practice Address - Phone:305-378-5247
Practice Address - Fax:305-378-6760
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT15367225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT15367OtherDEPT. OF HEALTH PROFESSIONAL LICENSE