Individual
MR. CARL LEONIDAS LOVERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
601 E ROLLINS ST, ORLANDO, FL 32803
(407) 303-7283
(407) 303-0347
Mailing address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-7283
(407) 303-0347
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104074
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292583400
—
FL
Enumeration date
06/12/2006
Last updated
08/23/2018
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