Provider Demographics
NPI:1336365246
Name:RIERA, LORENZO RAMON (MD)
Entity type:Individual
Prefix:
First Name:LORENZO
Middle Name:RAMON
Last Name:RIERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16864 SW 145TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2015
Mailing Address - Country:US
Mailing Address - Phone:305-963-9815
Mailing Address - Fax:305-963-9815
Practice Address - Street 1:5455 SW 8TH ST STE 235
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2270
Practice Address - Country:US
Practice Address - Phone:305-922-9714
Practice Address - Fax:786-803-8651
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN797208D00000X
PR013581208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL126428300Medicaid
FL1336365246OtherACN 797