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NPI Code Detail

MEDICARE: EDELEEN LOZADA

MEDICARE: EDELEEN LOZADA
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
1106S00000XBehavior TechnicianRBT-26-539107GA

General Provider Information

NPI Number : 1417887399
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDELEEN LOZADA
Provider Business Mailing Address
First Line : 103 W GENERAL SCREVEN WAY STE G
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-3053
Country : US
Telephone Number : 912-532-9774
Fax Number : 912-532-9774
Provider Business Practice Location Address
First Line : 481 ELMA G MILES PKWY STE B
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-4004
Country : US
Telephone Number : 912-532-9774
Fax Number : 912-221-3085
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2026
Last Update Date : 05/21/2026

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Directions to “ EDELEEN LOZADA ” Practice Location

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