Provider Demographics
NPI:1326341579
Name:JANICE R LORENZEN MD LLC
Entity Type:Organization
Organization Name:JANICE R LORENZEN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:R
Authorized Official - Last Name:LORENZEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-343-7805
Mailing Address - Street 1:PO BOX 1738
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-1738
Mailing Address - Country:US
Mailing Address - Phone:352-343-7805
Mailing Address - Fax:
Practice Address - Street 1:1807 SALK AVE
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-4311
Practice Address - Country:US
Practice Address - Phone:352-343-7805
Practice Address - Fax:353-343-8917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty