Provider Demographics
NPI:1568012599
Name:TOBIN, LORRAINE MARIE
Entity type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:MARIE
Last Name:TOBIN
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 1:12190 WELLESLEY CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8327
Mailing Address - Country:US
Mailing Address - Phone:917-952-4524
Mailing Address - Fax:
Practice Address - Street 1:12190 WELLESLEY CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8327
Practice Address - Country:US
Practice Address - Phone:917-952-4524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider