Individual
DR. RICHARD JAMES DELORENZO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
307 BOATNER RD, EGLIN AFB, FL 32542-1302
(850) 883-8272
Mailing address
307 BOATNER RD, EGLIN AFB, FL 32542-1302
(850) 883-8272
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
176008-1
NY
2083A0100X
Aerospace Medicine Physician
176008-1
NY
2083X0100X
Occupational Medicine Physician
Primary
176008-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176008-1
LICENSE
NY
Enumeration date
03/03/2006
Last updated
05/02/2018
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