Healthcare Provider Details

I. General information

NPI: 1609865336
Provider Name (Legal Business Name): LORENA KAELBER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NW 7TH AVE PHOENIX OBSTETRICS/GYNECOLOGY, LLC
FT LAUDERDALE FL
33311-9026
US

IV. Provider business mailing address

215 CAMERON CT
WESTON FL
33326-3521
US

V. Phone/Fax

Practice location:
  • Phone: 954-759-6789
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP2750862
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberARNP2750862
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP2750862
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: