Healthcare Provider Details

I. General information

NPI: 1134051709
Provider Name (Legal Business Name): LORENA PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14502 N DALE MABRY HWY
TAMPA FL
33618-2075
US

IV. Provider business mailing address

3207 N MORGAN ST
TAMPA FL
33603-5952
US

V. Phone/Fax

Practice location:
  • Phone: 813-265-3476
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH15974
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: