=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760589923
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ORLANDO LLORENTE MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2006
-----------------------------------------------------
Last Update Date | 08/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2645 SW 37TH AVE STE 603
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33133-2745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-712-2809
-----------------------------------------------------
Fax | 305-397-1487
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2645 SW 37TH AVE STE 603
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33133-2745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-712-2809
-----------------------------------------------------
Fax | 305-397-1487
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | ME99849
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------