Dominique Dilorenzo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME134088 Issued in FL

Practice address

1400 S Orlando Ave Ste 210
Winter Park, FL 32789-5543

Phone

(407) 409-8807

Fax

(407) 557-4885

NPI assigned

Apr 27, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Dominique Ghannam Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: ddilorenzo73881@adventhealth.direct-ci.com
• Direct secure messaging: dominique.dilorenzo@490822832881668.direct.elationemr.com
• Direct secure messaging: dominique.dilorenzo@621082629767172.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Zamzam Wellness LLC

  • Primary Care Clinic/Center
  • Winter Park, FL
  • NPI 1700692670
  Medicare reassignment NPD Authorized official
• Florida Hospital Medical Group Inc

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234
  Medicare reassignment NPD
• Florida Hospital Medical Group Inc

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1275910481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S ORLANDO AVE STE 210",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327895543",
            "telephone_number": "407-409-8807",
            "fax_number": "407-557-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S ORLANDO AVE STE 210",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327895543",
            "telephone_number": "407-409-8807",
            "fax_number": "407-557-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILORENZO",
        "first_name": "DOMINIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "FL",
            "license": "ME134088",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME134088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMINIQUE",
            "last_name": "GHANNAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jan Rosalyn Diehl, LPCC
• Ruth Diehl
• William H Dierdorf
• Ruth Cecilia Diez Arteaga, A.P
• Johnny Diggs III, C.P.T.
• Terrie M Dimos, LMT
• Andrea Dinon
• Hazel Dionne, MD
• Direct Behavioral Strategies LLC
• Erin Dominique Diskin, PA-C

• Family Medicine Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.