Provider Demographics
NPI:1255113882
Name:CARO LORENZO, VICTORIA DEL MAR
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:DEL MAR
Last Name:CARO LORENZO
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 1:6251 PALM TRACE LANDINGS DR APT 4-0118
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-1841
Mailing Address - Country:US
Mailing Address - Phone:787-422-9912
Mailing Address - Fax:
Practice Address - Street 1:6251 PALM TRACE LANDINGS DR APT 4-0118
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-1841
Practice Address - Country:US
Practice Address - Phone:787-422-9912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL46036390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program