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General NPI Number Information
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NPI Number | 1629951140
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Entity Type | Organization
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Legal Business Name | LORIG SERVICES CORP
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 7850 NW 146TH ST STE 301
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1519
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Country | US
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Telephone | 305-434-0356
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Fax |
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Provider Business Mailing Address
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Address Line | 7850 NW 146TH ST STE 301
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1519
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Country | US
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Telephone | 305-434-0356
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | SURAFEL K GEBRESELASSIE
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Credential | MD
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Telephone | 305-434-0356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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