Provider Demographics
NPI:1922466317
Name:URRUTIA, LORENA
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:URRUTIA
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 1:13217 SW 85TH STREET RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4156
Mailing Address - Country:US
Mailing Address - Phone:305-801-3174
Mailing Address - Fax:
Practice Address - Street 1:10 NW 42ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5473
Practice Address - Country:US
Practice Address - Phone:305-643-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker