Provider Demographics
NPI:1447435979
Name:REBECCA LORD, PA
Entity type:Organization
Organization Name:REBECCA LORD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:LORD
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:727-796-0001
Mailing Address - Street 1:202 9TH AVE S
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-3861
Mailing Address - Country:US
Mailing Address - Phone:727-796-0001
Mailing Address - Fax:727-796-0012
Practice Address - Street 1:202 9TH AVE S
Practice Address - Street 2:SUITE C
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-3861
Practice Address - Country:US
Practice Address - Phone:727-796-0001
Practice Address - Fax:727-796-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1655171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty