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General NPI Number Information
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NPI Number | 1316228141
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Entity Type | Organization
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Legal Business Name | DELORENZI ORTHOPAEDIC CENTER PA
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 7000 SPYGLASS CT SUITE 220
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City | VIERA
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State | FL
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Zip | 32940
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Country | US
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Telephone | 321-622-8622
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Fax | 321-622-8624
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Provider Business Mailing Address
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Address Line | 7000 SPYGLASS CT SUITE 220
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City | MELBOURNE
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State | FL
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Zip | 32940-8288
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Country | US
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Telephone | 321-622-8622
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Fax | 321-622-8624
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Authorized Official
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Title or Position | OWNER
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Name | RAYMOND J. DELORENZI
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Credential | M.D.
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Telephone | 321-622-8622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | FL
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