Provider Demographics
NPI:1902906381
Name:WEMLINGER, LORI (MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:WEMLINGER
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 1:1020 LAKE SUMTER LNDG
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-2699
Mailing Address - Country:US
Mailing Address - Phone:352-674-8905
Mailing Address - Fax:352-674-8919
Practice Address - Street 1:1575 SANTA BARBARA BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6820
Practice Address - Country:US
Practice Address - Phone:352-674-1720
Practice Address - Fax:352-674-8940
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036070011207R00000X
FLME116531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHJ204ZOtherPTAN
ILIL2613OtherMEDICARE GROUP PTAN
ILIL2613016Medicare PIN
ILIL2613OtherMEDICARE GROUP PTAN
FLHJ204ZMedicare Oscar/Certification