Organization

Lourdes Loreto Md Pa

Internal Medicine Physician in Tampa, FL(View on Map)

Legal Business Name

Lourdes Loreto Md Pa

NPI Number

1013108984

NPI Type

Organization

Enumeration Date

08/06/2007

Specialties

(Taxonomies)

Code

207R00000X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

ME29045

Contact
Information

Purpose

Mailing
Location

Address

4710 N HABANA AVE
4710 N HABANA AVE

City

Tampa
Tampa

State

FL
FL

Postal Code

33614
33614

Country

US
US

Telephone Number

(813) 877-3902
(813) 877-3902

Authorized Official

Name

Lourdes Loreto

Title or Position

PHYSICIAN

Telephone Number

(813) 877-3902

Identifiers

Identifier

057966100
29972
407112745

Identifier State

FL
FL
FL

Identifier Issuer

Unknown
BLUE CROSS BLUE SHIELD
RAILROAD MEDICARE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/05/2008

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