Provider Demographics
NPI:1053169482
Name:BRIONES, LORA NICOLE
Entity type:Individual
Prefix:MISS
First Name:LORA
Middle Name:NICOLE
Last Name:BRIONES
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 1:4821 DIAMONDS PALM LOOP
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7160
Mailing Address - Country:US
Mailing Address - Phone:813-819-4298
Mailing Address - Fax:
Practice Address - Street 1:4821 DIAMONDS PALM LOOP
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-7160
Practice Address - Country:US
Practice Address - Phone:813-819-4298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider