MEDICARE: TERESA E LOZANO MD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	ME88197	FL
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DN17503	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1760494678	OTHER	FL	GROUP NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316100464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA E LOZANO MD DDS

Provider Business Mailing Address
First Line	:	1155 BRICKELL BAY DR APT 1103
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33131-2998
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1155 BRICKELL BAY DR APT 1103
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33131-2998
Country	:	US
Telephone Number	:	305-804-9074
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2008
Last Update Date	:	04/06/2016

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Directions to “ TERESA E LOZANO MD DDS” Practice Location

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