Provider Demographics
NPI:1114065331
Name:LORENZO, EDUARDO E (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:E
Last Name:LORENZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4779 COLLINS AVE
Mailing Address - Street 2:APT. 1207
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3251
Mailing Address - Country:US
Mailing Address - Phone:305-586-3312
Mailing Address - Fax:
Practice Address - Street 1:4779 COLLINS AVE
Practice Address - Street 2:APT. 1207
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3251
Practice Address - Country:US
Practice Address - Phone:305-586-3312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95110208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice