Provider Demographics
NPI:1528137700
Name:FERRARA, LORI ANN (MD)
Entity type:Individual
Prefix:MS
First Name:LORI ANN
Middle Name:
Last Name:FERRARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 E ATLANTIC AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5360
Mailing Address - Country:US
Mailing Address - Phone:561-243-8800
Mailing Address - Fax:561-243-8787
Practice Address - Street 1:777 E ATLANTIC AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5360
Practice Address - Country:US
Practice Address - Phone:561-243-8800
Practice Address - Fax:561-243-8787
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68005174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27774OtherBLUE CROSS BLUE SHIELD
FLG12901Medicare UPIN
FL27774AMedicare ID - Type Unspecified