Provider Demographics
NPI:1316113194
Name:L R DIAGNOSTIC & TREATMENT CENTER INC
Entity type:Organization
Organization Name:L R DIAGNOSTIC & TREATMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:305-556-4149
Mailing Address - Street 1:1840 W 49TH ST
Mailing Address - Street 2:SUITE 605
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2942
Mailing Address - Country:US
Mailing Address - Phone:305-556-4149
Mailing Address - Fax:305-556-4149
Practice Address - Street 1:1840 W 49TH ST
Practice Address - Street 2:SUITE 605
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2942
Practice Address - Country:US
Practice Address - Phone:305-556-4149
Practice Address - Fax:305-556-4149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty