Provider Demographics
NPI:1417517764
Name:RODRIGUES SILVA SOMBRA, LORENNA (MD)
Entity Type:Individual
Prefix:
First Name:LORENNA
Middle Name:
Last Name:RODRIGUES SILVA SOMBRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LORENNA
Other - Middle Name:
Other - Last Name:SOMBRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100238
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0238
Mailing Address - Country:US
Mailing Address - Phone:352-733-1234
Mailing Address - Fax:352-265-0379
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3018
Practice Address - Country:US
Practice Address - Phone:352-265-0239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT217598207R00000X
FLME154614207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine