Healthcare Provider Details

I. General information

NPI: 1316195415
Provider Name (Legal Business Name): FRANK E LOZANO JR. D.M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 12/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 NW 43RD ST SUITE 16
GAINESVILLE FL
32606-7469
US

IV. Provider business mailing address

2441 NW 43RD ST SUITE 16
GAINESVILLE FL
32606-6676
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-7335
  • Fax: 352-378-5769
Mailing address:
  • Phone: 352-376-7335
  • Fax: 352-378-5769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN16773
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: