Provider Demographics
NPI:1780373795
Name:LORENZO CERRA, RICARDO ANTONIO
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:ANTONIO
Last Name:LORENZO CERRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LOS PRADOS SUR 81 CALLE DIAMANTE
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-9644
Mailing Address - Country:US
Mailing Address - Phone:787-918-5588
Mailing Address - Fax:
Practice Address - Street 1:81 CALLE DIAMANTE
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-9644
Practice Address - Country:US
Practice Address - Phone:787-918-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer