Healthcare Provider Details

I. General information

NPI: 1568487924
Provider Name (Legal Business Name): JOSE JAVIER CRUZ-LOZANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CASIA ST
SAN JUAN PR
00921
US

IV. Provider business mailing address

348 PASEO LAS OLAS TIBURON ST.
DORADO PR
00646-4653
US

V. Phone/Fax

Practice location:
  • Phone: 787-796-2776
  • Fax: 787-796-2776
Mailing address:
  • Phone: 787-796-2776
  • Fax: 787-796-2776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number13369
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: