Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME0065127 | FL |
NPI | 1003816273 |
---|---|
Provider Name | Dr. Lori Ann Mcauliffe |
First Address | St Petersburg, FL 33707-2101 |
Second Address | St Petersburg, FL 33707-2101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
26750 | BLUECROSS BLUE SHIELD (01) | FL |