Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 57354 | TN |
Y | 207Q00000X | Family Doctor | ME134088 | FL |
N | 207V00000X | Obstetrician & Gynecologist | 57354 | TN |
N | 207VX0000X | Obstetrician | ME134088 | FL |
NPI | 1275910481 |
---|---|
Provider Name | Dominique Dilorenzo |
First Address | Orlando, FL 32822-8204 |
Second Address | Orlando, FL 32822-8204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2015 |
Last Update Date | 11/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q038804 | (05) | TN |