Provider Demographics
NPI:1922480300
Name:LORITES MEDICAL GROUP M.D. P.A & ASSOCIATES
Entity Type:Organization
Organization Name:LORITES MEDICAL GROUP M.D. P.A & ASSOCIATES
Other - Org Name:LORITES MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:LORITES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-460-0045
Mailing Address - Street 1:8300 W FLAGLER ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-6000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8300 W FLAGLER ST
Practice Address - Street 2:SUITE 112
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-6000
Practice Address - Country:US
Practice Address - Phone:305-460-0045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORITES MEDICAL GROUP M.D. P.A & ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95227208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ0006Medicare PIN