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General NPI Number Information
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NPI Number | 1184218232
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Entity Type | Individual
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Provider Name | MICHELLE LOZADA MARTINEZ MD
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Gender | Female
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Dates
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Enumeration Date | 03/01/2021
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | SUITE G DAVISON PLAZA, COMERIO AVE
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-975-5050
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Fax |
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Provider Business Mailing Address
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Address Line | NC26 CAMINO DE LOS ABADES LA MANSION
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-366-7069
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 15689I
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 22721
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License Number State | PR
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