Provider Demographics
NPI:1427308691
Name:ADJUDER, LENORA
Entity type:Individual
Prefix:
First Name:LENORA
Middle Name:
Last Name:ADJUDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 SW KAYAK AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-6426
Mailing Address - Country:US
Mailing Address - Phone:772-834-9478
Mailing Address - Fax:
Practice Address - Street 1:654 SW KAYAK AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-6426
Practice Address - Country:US
Practice Address - Phone:772-834-9478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle