Healthcare Provider Details

I. General information

NPI: 1093364184
Provider Name (Legal Business Name): MEYLING M LORENZO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2019
Last Update Date: 09/29/2026
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3259 NW 99TH ST
MIAMI FL
33147-1934
US

IV. Provider business mailing address

3259 NW 99TH ST
MIAMI FL
33147-1934
US

V. Phone/Fax

Practice location:
  • Phone: 786-406-0973
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCBHCMS0102821
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: