=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801758529
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MS. OLGA LIDIA BAZART LORENZO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2025
-----------------------------------------------------
Last Update Date | 12/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 375 S ROYAL POINCIANA BLVD APT 3A
-----------------------------------------------------
City | MIAMI SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33166-6165
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-212-8777
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 375 S ROYAL POINCIANA BLVD APT 3A
-----------------------------------------------------
City | MIAMI SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33166-6165
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-212-8777
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number | RBT-25-486919
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------