Healthcare Provider Details

I. General information

NPI: 1396241436
Provider Name (Legal Business Name): ANA LOZANO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 MEDICAL PARK BLVD STE 405
WELLINGTON FL
33414-3183
US

IV. Provider business mailing address

1447 MEDICAL PARK BLVD STE 405
WELLINGTON FL
33414-3183
US

V. Phone/Fax

Practice location:
  • Phone: 561-767-8342
  • Fax:
Mailing address:
  • Phone: 561-767-8342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS21206
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberOS21206
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: