Provider Demographics
NPI:1972161800
Name:ROSERO, LORENA
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:ROSERO
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 1:4302 ALTON RD STE 920
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2890
Mailing Address - Country:US
Mailing Address - Phone:305-674-2655
Mailing Address - Fax:
Practice Address - Street 1:4302 ALTON RD STE 920
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2890
Practice Address - Country:US
Practice Address - Phone:305-674-2655
Practice Address - Fax:305-695-7668
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME16234207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology