Healthcare Provider Details

I. General information

NPI: 1063304822
Provider Name (Legal Business Name): LORENZO MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 W FLAGLER ST STE 113
MIAMI FL
33144-2037
US

IV. Provider business mailing address

8550 W FLAGLER ST STE 113
MIAMI FL
33144-2037
US

V. Phone/Fax

Practice location:
  • Phone: 786-975-8588
  • Fax:
Mailing address:
  • Phone: 786-975-8588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAVID O ALDUNCIN
Title or Position: CEO
Credential: APRN
Phone: 786-975-8528