Individual
ALYSE BARBARA LORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4340 NEWBERRY RD STE 301, GAINESVILLE, FL 32607-2557
(352) 372-9414
Mailing address
244 WARREN COVE LN, LENOIR CITY, TN 37772-3986
(865) 964-9587
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA911866
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3SM0Z
BCBS
FL
Enumeration date
01/27/2025
Last updated
04/17/2025
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