Provider Demographics
NPI:1013961440
Name:DRUCKER, LORI BOLDT (ARNP)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:BOLDT
Last Name:DRUCKER
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 1:5700 LAKE WORTH RD STE 204
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3213
Mailing Address - Country:US
Mailing Address - Phone:561-968-7968
Mailing Address - Fax:561-964-4603
Practice Address - Street 1:120 JFK DR
Practice Address - Street 2:MEDICAL SPECIALISTS OF THE PLAM BEACHES
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462
Practice Address - Country:US
Practice Address - Phone:561-968-6767
Practice Address - Fax:561-641-0814
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1285142363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S25326Medicare UPIN
Y5785ZMedicare ID - Type Unspecified