Individual
DR. OMAR LORENZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
5801 NW 151ST ST STE 202, MIAMI LAKES, FL 33014-2437
(305) 557-6755
(305) 557-1636
Mailing address
5801 NW 151ST ST STE 202, MIAMI LAKES, FL 33014-2437
(305) 557-6755
(305) 557-1636
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY7210
FL
103T00000X
Psychologist
PY7210
FL
103TC0700X
Clinical Psychologist
PY7210
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11606395
CAQH PROVIDER ID
FL
01
—
75335
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/01/2006
Last updated
06/16/2022
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