MEDICARE: JOSEFINA LOZANO

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	208D00000X	General Practice Physician	ACN363	FL

General Provider Information

NPI Number	:	1457554297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEFINA LOZANO

Provider Business Mailing Address
First Line	:	6161 SUNSET DR STE B
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5045
Country	:	US
Telephone Number	:	305-663-1113
Fax Number	:	305-663-1119

Provider Business Practice Location Address
First Line	:	6161 SUNSET DR STE B
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5045
Country	:	US
Telephone Number	:	305-663-1113
Fax Number	:	305-663-1119

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

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	12/10/2020

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