Provider Demographics
NPI:1003785601
Name:ELIZONDO, LORENA (NP)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:ELIZONDO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 NW 29TH ST APT 506
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-3944
Mailing Address - Country:US
Mailing Address - Phone:281-979-3936
Mailing Address - Fax:
Practice Address - Street 1:286 NW 29TH ST APT 506
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-3944
Practice Address - Country:US
Practice Address - Phone:281-979-3936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF09251061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily