Provider Demographics
NPI:1992753024
Name:DILORENZO, MARCUS J (MD)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:J
Last Name:DILORENZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3858
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-3858
Mailing Address - Country:US
Mailing Address - Phone:352-732-5550
Mailing Address - Fax:352-369-6687
Practice Address - Street 1:1302 SE 25TH LOOP
Practice Address - Street 2:STE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-1027
Practice Address - Country:US
Practice Address - Phone:352-732-5550
Practice Address - Fax:352-369-6687
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0045390174400000X
FLME45390207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL041770000Medicaid
FL42201OtherBCBS
FL041770000Medicaid