Clinica San Antonio PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

CLINICA SAN ANTONIO PLLC

Practice address

416 McCullough Dr Ste 110
Charlotte, NC 28262-4387

Phone

(980) 613-8735

Fax

(980) 613-8079

NPI assigned

Feb 12, 2020

Last updated

Feb 12, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gilberto Lorenzana, NPNPI 1922660869

Title

Owner

Phone

(980) 613-8735

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gilberto Antonio Lorenzana

  • Family Nurse Practitioner
  • Charlotte, NC
  • NPI 1922660869
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1619509197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 MCCULLOUGH DR STE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624387",
            "telephone_number": "980-613-8735",
            "fax_number": "980-613-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 MCCULLOUGH DR STE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624387",
            "telephone_number": "980-613-8735",
            "fax_number": "980-613-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA SAN ANTONIO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "LORENZANA",
        "authorized_official_first_name": "GILBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "980-613-8735",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Derek Cline, MD
• Stormy Addrianna Cline
• Xavier Cline
• Kendra Mae Clingerman, PA-C
• Clinica Hispana Las Carolinas PLLC
• Karrisa Clinkscales
• Tomeka Latonya Clinkscales, FNP
• Clinworks, Inc.
• Clio Laboratory, LLC
• Jean L. Caroline Clippard

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.