Provider Demographics
NPI:1457186918
Name:TONIOLI, LORY LETHA (FNP-C)
Entity type:Individual
Prefix:
First Name:LORY
Middle Name:LETHA
Last Name:TONIOLI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LORY
Other - Middle Name:LETHA
Other - Last Name:TONIOLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1527 EAGLES CIR
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-6471
Mailing Address - Country:US
Mailing Address - Phone:772-696-1626
Mailing Address - Fax:
Practice Address - Street 1:1986 31ST AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6628
Practice Address - Country:US
Practice Address - Phone:772-257-5390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035047207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology