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General NPI Number Information
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NPI Number | 1295525756
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Entity Type | Organization
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Legal Business Name | MI DOC MEDICAL INSTITUTE LLC
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 300 SECTOR CUESTA LOS JOBOS
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City | HUMACAO
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State | PR
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Zip | 00792-8630
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Country | US
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Telephone | 787-475-5444
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 13498
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City | HUMACAO
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State | PR
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Zip | 00791-9364
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Country | US
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Telephone | 787-475-5444
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LORNA DIAZ LOZADA
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Credential | MD
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Telephone | 787-475-5444
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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 |
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License Number State |
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