Provider Demographics
NPI:1902293889
Name:LORCH, KATHERINE ARMINE (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ARMINE
Last Name:LORCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ARMINE
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3621 KEARSNEY ABBEY CIR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:FL
Mailing Address - Zip Code:33527-6390
Mailing Address - Country:US
Mailing Address - Phone:915-276-7656
Mailing Address - Fax:
Practice Address - Street 1:1920 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-2902
Practice Address - Country:US
Practice Address - Phone:863-683-4661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-18
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME149510208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program