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General NPI Number Information
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NPI Number | 1790853166
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Entity Type | Individual
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Provider Name | OMAR LORENZO PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 5801 NW 151ST ST STE 202
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2437
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Country | US
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Telephone | 305-557-6755
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Fax | 305-557-1636
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Provider Business Mailing Address
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Address Line | 5801 NW 151ST ST STE 202
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2437
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Country | US
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Telephone | 305-557-6755
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Fax | 305-557-1636
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY7210
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY7210
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY7210
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License Number State | FL
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