Individual
DR. LORENZO S BONGOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3424 W KENNEDY BLVD, TAMPA, FL 33609-2906
(813) 873-8877
(813) 870-2464
Mailing address
3424 W KENNEDY BLVD, TAMPA, FL 33609-2906
(813) 873-8877
(813) 870-2464
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME27892
FL
Other
Enumeration date
03/19/2010
Last updated
03/19/2010
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