MEDICARE: ALMA ANGELICA LOZANO MERCADO FNP-C

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	363LP2300X	Primary Care Nurse Practitioner	1088309	TX
2	163W00000X	Registered Nurse	934722	TX

General Provider Information

NPI Number	:	1417573239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALMA ANGELICA LOZANO MERCADO FNP-C

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	407-533-6836
Fax Number	:	407-770-0661

Provider Business Practice Location Address
First Line	:	122 SAINT CLOUD RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-5009
Country	:	US
Telephone Number	:	726-240-6949
Fax Number	:	210-761-3397

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

Provider Enumeration Date	:	06/17/2020
Last Update Date	:	03/26/2026

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