Provider Demographics
NPI:1326272733
Name:ANNE LORD DO, PA
Entity type:Organization
Organization Name:ANNE LORD DO, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LORD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-656-9006
Mailing Address - Street 1:12650 WORLD PLAZA LN BLDG 72-2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-4077
Mailing Address - Country:US
Mailing Address - Phone:239-656-9006
Mailing Address - Fax:239-236-1595
Practice Address - Street 1:12650 WORLD PLAZA LN BLDG 72
Practice Address - Street 2:SUITE 2
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3987
Practice Address - Country:US
Practice Address - Phone:239-656-9006
Practice Address - Fax:239-372-0269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9883207VG0400X
FLOS9878208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU8346ZMedicare UPIN
FLU8746ZMedicare UPIN