MEDICARE: MRS. NORMA IRIS PRATS LOZADA LND

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	133N00000X	Nutritionist	237	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NUT / 012	OTHER	PR	PREFERRED HEALTH PLAN

General Provider Information

NPI Number	:	1942240049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NORMA IRIS PRATS LOZADA LND

Provider Business Mailing Address
First Line	:	1937 CALLE 46
Second Line	:	URB. FAIRVIEW
City	:	SAN JUAN
State	:	PR
Zip	:	00926-7636
Country	:	US
Telephone Number	:	787-292-1552
Fax Number	:	787-763-4278

Provider Business Practice Location Address
First Line	:	1056 CALLE FERROCARRIL
Second Line	:	SUITE #1
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00925-3028
Country	:	US
Telephone Number	:	787-764-8937
Fax Number	:	787-763-4278

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	07/14/2010

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