Provider Demographics
NPI:1205839396
Name:HELMAN, LORI MILLS (OD)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:MILLS
Last Name:HELMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:708 BROADOAK LOOP
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7184
Mailing Address - Country:US
Mailing Address - Phone:407-415-9602
Mailing Address - Fax:
Practice Address - Street 1:2303 S BAY ST
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6360
Practice Address - Country:US
Practice Address - Phone:352-357-1027
Practice Address - Fax:352-357-1029
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP0002247152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078706000Medicaid
FL410023143OtherRAILROAD MEDICARE
FL078706000Medicaid
19314Medicare ID - Type Unspecified
FL97872Medicare PIN