Individual
LORRAINE MARIE RICCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1290 CELEBRATION BLVD, KISSIMMEE, FL 34747-4692
(321) 337-7454
Mailing address
575 CAMPUS ST, CELEBRATION, FL 34747-4613
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28193
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80634407
HEALTH CARE PROVIDER
—
Enumeration date
06/19/2019
Last updated
06/19/2019
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