| Entity Name: | LORI MCAULIFFE, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Feb 2000 (25 years ago) |
| Document Number: | P00000015482 |
| FEI/EIN Number | 593623752 |
| Address: | 405 SOUTH PASEDENA AVENUE, ST PETERSBURG, FL, 33707 |
| Mail Address: | 405 SOUTH PASEDENA AVENUE, ST PETERSBURG, FL, 33707 |
| ZIP code: | 33707 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447238969 | 2006-01-04 | 2008-05-21 | 405 PASADENA AVE S, SAINT PETERSBURG, FL, 337072101, US | 405 PASADENA AVE S, SAINT PETERSBURG, FL, 337072101, US | |||||||||||||||||||||||||
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| Phone | +1 727-345-2212 |
| Fax | 7273813444 |
Authorized person
| Name | DR. LORI A MCAULIFFE |
| Role | PRESIDENT |
| Phone | 7273452212 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME0065127 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUECROSS |
| Number | 00845 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MCAULIFFE KEVIN J | Agent | 405 SOUTH PASEDENA AVENUE, ST PETERSBURG, FL, 33707 |
| Name | Role | Address |
|---|---|---|
| MCAULIFFE LORI M | President | 405 SOUTH PASADENA AVENUE, SAINT PETERSBURG, FL, 33707 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
