Individual
LORI MAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
59 EDGE PARK TRL, ST AUGUSTINE, FL 32086-1919
(386) 546-6213
Mailing address
59 EDGE PARK TRL, ST AUGUSTINE, FL 32086-1919
(386) 546-6213
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5194282
FL
Other
Enumeration date
06/18/2026
Last updated
06/18/2026
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