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General NPI Number Information
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NPI Number | 1720304314
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Entity Type | Individual
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Provider Name | CAROLYN D. LORENC M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 1900 BROTHER GEENEN WAY
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City | SARASOTA
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State | FL
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Zip | 34236-7102
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Country | US
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Telephone | 941-556-3215
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Fax |
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Provider Business Mailing Address
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Address Line | 7718 LAKE VISTA CT UNIT 307
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-2123
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Country | US
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Telephone | 941-907-0423
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME0048226
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License Number State | FL
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