Healthcare Provider Details

I. General information

NPI: 1609280726
Provider Name (Legal Business Name): LORRAINE CUADROS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10011 SEMINOLE BLVD
SEMINOLE FL
33772-2539
US

IV. Provider business mailing address

10011 SEMINOLE BLVD
SEMINOLE FL
33772-2539
US

V. Phone/Fax

Practice location:
  • Phone: 727-393-2800
  • Fax: 727-456-1588
Mailing address:
  • Phone: 727-393-2800
  • Fax: 727-456-1588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME137198
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: