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NPI Code Detail

MEDICARE: DR. LORENZO MIL CORPUS M.D.

MEDICARE: DR. LORENZO MIL CORPUS M.D.
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
1207Q00000XFamily Medicine PhysicianME64468FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689641110
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORENZO MIL CORPUS M.D.
Provider Business Mailing Address
First Line : 2675 WINKLER AVE FL 2
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9342
Country : US
Telephone Number : 877-856-3774
Fax Number :
Provider Business Practice Location Address
First Line : 8093 NORMANDY BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-6646
Country : US
Telephone Number : 904-337-2050
Fax Number : 904-337-2051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 10/06/2021

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