Individual
DR. LORRAINE FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
18590 NW 67TH AVE, SUITE # 101, HIALEAH, FL 33015-3306
(305) 819-8633
(305) 819-8630
Mailing address
PO BOX 566417, MIAMI, FL 33256-6417
(305) 819-8633
(305) 819-8630
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
3954626
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374515500
—
FL
Enumeration date
10/13/2006
Last updated
07/09/2007
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