MEDICARE: MR. CARMINE LORENZO LOMBARDOZZI PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	9120938.	FL
2	363A00000X	Physician Assistant	PA19746	TX

General Provider Information

NPI Number	:	1245104330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARMINE LORENZO LOMBARDOZZI PA-C

Provider Business Mailing Address
First Line	:	2365 FLAMINGO WAY
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-1628
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25511 BUDDE RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77380-2080
Country	:	US
Telephone Number	:	281-466-4644
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	11/25/2025

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