LORI L COSTA (NPI# 1639421332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639421332 |
| Entity Type | Individual |
| Full Name | LORI L COSTA |
| Credential | NP-C |
| Practice Address |
10080 Sw Innovation Way Ste 102 Port St Lucie FL 34987-2129 |
| Mailing Address |
Po Box 417 Stuart FL 34995-0417 |
| Practice Telephone | 7723443811 |
| Practice Fax Number | 7727955531 |
| Mailing Telephone | 7722232832 |
| Mailing Fax Number | 7722235653 |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2020-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP9329122 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 015425400 | 05 | |
| FL | FLORIDA BLUE | 1FK6O | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457730525 | Lori Costa | Social Worker | 1061 Pleasant St, New Bedford, MA 02740-6728 | 2015-05-22 |
| Street Address |
10080 SW INNOVATION WAY STE 102 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34987-2129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740392406 | Valerie Ann Ward | Nurse Practitioner | 10080 Sw Innovation Way Ste 102, Port St Lucie, FL 34987-2129 | 2006-08-31 |
| 1407365513 | Martin Memorial Physicians Corp | Pharmacy | 10080 Sw Innovation Way Ste 102, Port St Lucie, FL 34987-2129 | 2017-09-21 |
| 1245777929 | Justin D Wasdin | Physician Assistant | 10080 Sw Innovation Way Ste 102, Port St Lucie, FL 34987-2129 | 2017-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093299604 | Karen Cecilia Wong Li James | Registered Nurse | 10024 Sw Glenbrook Drive, Port Saint Lucie, FL 34987 | 2018-09-19 |
| 1134646151 | B & T Diagnostics LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 323, Port Saint Lucie, FL 34987 | 2017-08-30 |
| 1538684048 | Transport With Care, LLC | Non-emergency Medical Transport (VAN) | 1850 Sw Our Ct, Port Saint Lucie, FL 34987 | 2017-08-04 |
| 1154859825 | True Path Diagnostics, LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 309, Port St Lucie, FL 34987 | 2017-05-25 |
| 1316326515 | Aleksey Alekseyenko | Family Medicine | Mhpg Primary Care @ Tradition Health Park II, 10080 Sw Innovation Way Suite 201, Port St Lucie, FL 34987 | 2015-05-21 |
| 1053658583 | Tameka Argo | Contractor | 7664 Germany Canal Road, Fort Pierce, FL 34987 | 2013-01-03 |
| 1780967976 | Mennette J Colon | Specialist/Technologist, Other | 1970 Sw Glendale St., Port Saint Lucie, FL 34987 | 2011-09-23 |
| 1366416257 | Cynthia A Dolan | Dermatology | 10080 Sw Innovation Way Ste 301, Port St Lucie, FL 34987 | 2006-02-15 |
| 1205829074 | Andres M Reyes | Internal Medicine | 10050 Nw Innovation Way, Suite 102, Port St Lucie, FL 34987 | 2005-08-26 |
| 1720498470 | Josue Limage | Family Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987 | 2014-05-03 |
| Find all providers in zip 34987 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629682331 | Altagrace Jean Baptiste | Nurse Practitioner | 5934 Nw Dowell Ct, Port St Lucie, FL 34986-3831 | 2020-09-01 |
| 1659983336 | Ingrid Debbieann Marsden | Nurse Practitioner | 439 Nw Prima Vista Blvd, Port St Lucie, FL 34983-8731 | 2020-08-23 |
| 1518503044 | Ruth Simon | Nurse Practitioner | 3029 Se Galt Cir, Port St Lucie, FL 34984-6339 | 2019-11-19 |
| 1578104816 | Paulard Bernard | Nurse Practitioner | 4112 Sw Webb St, Port St Lucie, FL 34953-5956 | 2019-10-07 |
| 1386205623 | Jeanine C Marshall | Nurse Practitioner | 1266 Sw Asturia Ave, Port St Lucie, FL 34953-4829 | 2019-06-27 |
| 1881167013 | Sophia Powell | Nurse Practitioner | 1574 Sw Dycus Ave, Port St Lucie, FL 34953-5251 | 2019-01-10 |
| 1841787850 | Stacy Sweeney | Nurse Practitioner | 2823 Se Peru St, Port St Lucie, FL 34984-6212 | 2018-04-16 |
| 1528567583 | Roger Rene Trudel | Nurse Practitioner | 3686 Sw Carmody Street, Port St Lucie, FL 34953 | 2018-02-06 |
| 1831605146 | Lfc Family Home Health Solutions, LLC | Nurse Practitioner | 1542 Sw Latshaw Ave, Port St Lucie, FL 34953-7013 | 2017-12-21 |
| 1619489473 | Tammy Grisham | Nurse Practitioner | 714 Nw Leonardo Cir, Port St Lucie, FL 34986-4354 | 2017-11-01 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34987 |
Please comment or provide details below to improve the information on LORI L COSTA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.