Provider Demographics
NPI:1073160479
Name:CAROLLO, LORENZA CAROLINA
Entity Type:Individual
Prefix:
First Name:LORENZA
Middle Name:CAROLINA
Last Name:CAROLLO
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 1:6520 NW 114TH AVE APT 1627
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4586
Mailing Address - Country:US
Mailing Address - Phone:954-682-2985
Mailing Address - Fax:
Practice Address - Street 1:6520 NW 114TH AVE APT 1627
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4586
Practice Address - Country:US
Practice Address - Phone:954-682-2985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator