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General NPI Number Information
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NPI Number | 1316100464
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Entity Type | Individual
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Provider Name | TERESA E LOZANO MD DDS
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Gender | Female
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | 1155 BRICKELL BAY DR APT 1103
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City | MIAMI
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State | FL
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Zip | 33131-2998
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Country | US
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Telephone | 305-804-9074
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 BRICKELL BAY DR APT 1103
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City | MIAMI
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State | FL
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Zip | 33131-2998
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Country | US
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Telephone |
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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 | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | ME88197
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN17503
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License Number State | FL
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