Provider Demographics
NPI:1114120284
Name:LORENZO, YOHAMA (DMD)
Entity Type:Individual
Prefix:DR
First Name:YOHAMA
Middle Name:
Last Name:LORENZO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 DAYTONIA ROAD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141
Mailing Address - Country:US
Mailing Address - Phone:305-867-9457
Mailing Address - Fax:
Practice Address - Street 1:7000 SW 97TH AVE STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1492
Practice Address - Country:US
Practice Address - Phone:305-279-0717
Practice Address - Fax:305-279-0713
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL008097122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist