=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164509501
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NORAH LOZANO RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4360 OKEECHOBEE BLVD
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33409
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-616-3360
-----------------------------------------------------
Fax | 561-616-4320
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4960 127TH TRAIL NORTH
-----------------------------------------------------
City | ROYAL PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33411
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-333-8947
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PS29414
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------