MEDICARE: TERESA E LOZANO MD DDS PA

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

General Provider Information

NPI Number	:	1760494678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERESA E LOZANO MD DDS PA

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	:	305-379-6037
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	:	305-379-6037
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. TERESA ELENA LOZANO
Credential	:	MD, DDS
Telephone Number	:	305-379-6037

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	07/09/2008

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