Healthcare Provider Details

I. General information

NPI: 1548103369
Provider Name (Legal Business Name): MR. LORENZO MALAGUTH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2206 S CYPRESS BEND DR APT 402
POMPANO BEACH FL
33069-4437
US

IV. Provider business mailing address

2206 S CYPRESS BEND DR APT 402
POMPANO BEACH FL
33069-4437
US

V. Phone/Fax

Practice location:
  • Phone: 754-235-3473
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: