Provider Demographics
NPI:1477238152
Name:LORENZANA, MARCOS F
Entity Type:Individual
Prefix:
First Name:MARCOS
Middle Name:F
Last Name:LORENZANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7465 W LAKE MEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1032
Mailing Address - Country:US
Mailing Address - Phone:702-562-1245
Mailing Address - Fax:702-938-5887
Practice Address - Street 1:5195 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-1634
Practice Address - Country:US
Practice Address - Phone:775-505-4166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care