Individual
AWILDA LORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
500 GRAND PLAZA DR, ORANGE CITY, FL 32763-7900
(386) 775-0855
(386) 775-0274
Mailing address
500 GRAND PLAZA DR, ORANGE CITY, FL 32763-7900
(386) 775-0855
(386) 775-0274
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6119
FL
Other
Enumeration date
03/30/2009
Last updated
03/30/2009
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