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Individual

LEONARD DELORENZO III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
160 ALLEN ST, RUTLAND, VT 05701-4560
(802) 747-1831
(802) 747-1826
Mailing address
160 ALLEN ST, RUTLAND, VT 05701-4560
(802) 747-1831
(802) 747-1826

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055-0031054
VT
363A00000X
Physician Assistant
PA9101620
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
291646100
FL
Enumeration date
07/12/2006
Last updated
08/22/2013
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