Grant, Lori A
Grant, Lori A is an individual health care provider with primary practice located at 719 Rodel Cv Ste 2001 , Lake Mary FL 32746-5716. She recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Podiatrist is her primary health care specialty. Grant, Lori A can be contacted via phone (407) 878-4720.Contact Information
Primary practice address
719 Rodel Cv Ste 2001
Lake Mary FL 32746-5716
Phone: (407) 878-4720
Fax: (407) 878-4732
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | PO3334 | Florida |
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | PO3334 | Florida |
Profile Details
| NPI number | 1316188311 |
|---|---|
| LBN Legal business name | Grant, Lori A |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2009 |
| Last updated | May 22nd, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316188311 | NPPES |
| Florida | MEDICAID | 001457300 | |
| Florida | Other | 6500S |
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