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General NPI Number Information
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NPI Number | 1366719650
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Entity Type | Individual
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Provider Name | JOSE ANTONIO LOZANO MD, CSFA, OPA-C
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Gender | Male
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 1 UNIVERSITY BLVD UNIVERSITY OF SAINT AUGUSTINE
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5799
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Country | US
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Telephone | 904-826-0084
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Fax |
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Provider Business Mailing Address
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Address Line | 104 LAUREL WOOD WAY UNIT 104
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-3122
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Country | US
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Telephone | 786-863-0715
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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