MEDICARE: LORENZO CHAPA III

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP16484	AZ

General Provider Information

NPI Number	:	1033887187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORENZO CHAPA III

Provider Business Mailing Address
First Line	:	3836 CAT MINT ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-6938
Country	:	US
Telephone Number	:	361-660-8760
Fax Number	:

Provider Business Practice Location Address
First Line	:	3836 CAT MINT ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-6938
Country	:	US
Telephone Number	:	361-660-8760
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2021
Last Update Date	:	08/04/2025

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Directions to “ LORENZO CHAPA III ” Practice Location

Language	Start Address	Practice Location

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