Healthcare Provider Details
I. General information
NPI: 1801894233
Provider Name (Legal Business Name): ANA M SUAREZ LOZADA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/11/2005
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1065 AVE LOS CORAZONES EDIFICIO MEDICO PROFESIONAL OFICINAS 104,110 -111
MAYAGUEZ PR
00680-7060
US
IV. Provider business mailing address
PO BOX 6470
MAYAGUEZ PR
00681-6470
US
V. Phone/Fax
- Phone: 787-831-5922
- Fax: 787-831-5922
- Phone: 787-832-7522
- Fax: 787-832-7522
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 10301 |
| License Number State | PR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: