Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | DN17503 | FL |
Y | 204E00000X | Oral & Maxillofacial Surgeon | ME88197 | FL |
NPI | 1316100464 |
---|---|
Provider Name | Teresa E Lozano |
First Address | Miami, FL 33131-2998 |
Second Address | Miami, FL 33131-2998 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 06/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1760494678 | GROUP NPI (01) | FL |