Basic Information
| Provider Information | |||||||||
| NPI: | 1013961440 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DRUCKER | ||||||||
| FirstName: | LORI | ||||||||
| MiddleName: | BOLDT | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5700 LAKE WORTH RD STE 204 | ||||||||
| Address2: | |||||||||
| City: | GREENACRES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334633213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619687968 | ||||||||
| FaxNumber: | 5619644603 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 JFK DR | ||||||||
| Address2: | MEDICAL SPECIALISTS OF THE PLAM BEACHES | ||||||||
| City: | ATLANTIS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619686767 | ||||||||
| FaxNumber: | 5616410814 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2006 | ||||||||
| LastUpdateDate: | 09/07/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | ARNP1285142 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.