Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 11731 | PR |
NPI | 1104879550 |
---|---|
Provider Name | Carmen Teresa Lozada |
First Address | Caguas, PR 00726-7768 |
Second Address | San Juan, PR 00921-3200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 16/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1235189770 | HOSPITAL NPI (01) | PR |
G-41718 | (02) | PR |