Healthcare Provider Details

I. General information

NPI: 1932596525
Provider Name (Legal Business Name): ROBERT ALEXANDER LORCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 S FALKENBURG RD STE 201
RIVERVIEW FL
33578-2594
US

IV. Provider business mailing address

3140 S FALKENBURG RD STE 201
RIVERVIEW FL
33578-2594
US

V. Phone/Fax

Practice location:
  • Phone: 813-910-0030
  • Fax: 813-654-0478
Mailing address:
  • Phone: 813-910-0030
  • Fax: 813-654-0478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME143861
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: