Provider Demographics
NPI:1952905614
Name:LORENZO, GABRIEL (CSFA)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:LORENZO
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:683 WILLIAMS AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-6837
Mailing Address - Country:US
Mailing Address - Phone:407-692-0301
Mailing Address - Fax:
Practice Address - Street 1:683 WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-6837
Practice Address - Country:US
Practice Address - Phone:407-692-0301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty