Healthcare Provider Details

I. General information

NPI: 1619083680
Provider Name (Legal Business Name): HECTOR L LOZANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 05/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 AVE PONCE DE LEON STE 809 TORRE MEDICA AUXILIO MUTUO
SAN JUAN PR
00917-5031
US

IV. Provider business mailing address

735 AVE PONCE DE LEON STE 809 TORRE MEDICA AUXILIO MUTUO
SAN JUAN PR
00917-5031
US

V. Phone/Fax

Practice location:
  • Phone: 787-274-1282
  • Fax: 787-764-0898
Mailing address:
  • Phone: 787-274-1282
  • Fax: 787-764-0898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number15480
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: