Individual
LORENA FERNANDES REVOREDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5631 TELEPHONE RD STE B, HOUSTON, TX 77087-4485
(281) 727-0332
Mailing address
9290 LEGARE ST, BOCA RATON, FL 33434-5905
(561) 221-5189
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
9259079
FL
363LA2200X
Adult Health Nurse Practitioner
9259079
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
9259079
FL
363LP2300X
Primary Care Nurse Practitioner
9259079
FL
Other
Enumeration date
10/10/2018
Last updated
05/31/2023
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