Individual provider Active NPI

Mayra L Lorenzo, M.D.

  • Family Medicine Physician
  • Largo, FL
National Provider Identifier
1447251061
Registry record updated Jun 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME59120 Issued in FL
Practice address
12150 Seminole Blvd
Largo, FL 33778
Phone
(727) 216-6188
Fax
(727) 216-6242
NPI assigned
Aug 4, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME59120 FL Primary

Addresses

Primary practice location

12150 Seminole Blvd
Largo, FL 33778

Mailing address

14690 Spring Hill Dr
Suite 100 Attn:Credentialing
Spring Hill, FL 34609-8102
Phone (352) 799-0046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME59120FLMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496966400000",
    "number": "1447251061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14690 SPRING HILL DR",
            "address_2": "SUITE 100 ATTN:CREDENTIALING",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346098102",
            "telephone_number": "352-799-0046",
            "fax_number": "352-606-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 SEMINOLE BLVD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33778",
            "telephone_number": "727-216-6188",
            "fax_number": "727-216-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZO",
        "first_name": "MAYRA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-04",
        "last_updated": "2017-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME59120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.