Provider Demographics
NPI:1639691793
Name:LOUDIS, CHRISTINA LORELEI (LAP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LORELEI
Last Name:LOUDIS
Suffix:
Gender:F
Credentials:LAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1948 SAXON BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-4582
Mailing Address - Country:US
Mailing Address - Phone:305-300-7733
Mailing Address - Fax:
Practice Address - Street 1:1948 SAXON BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-4582
Practice Address - Country:US
Practice Address - Phone:305-300-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-11
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL157776171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty