Provider Demographics
NPI:1871660233
Name:PARAPAR, LORENA
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:PARAPAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6090 WEST 18 AVE
Mailing Address - Street 2:APTO 233
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6090 W 18TH AVE
Practice Address - Street 2:APTO 233
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6139
Practice Address - Country:US
Practice Address - Phone:786-222-8985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 43240171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL69148996 96Medicaid