Provider Demographics
NPI:1033226014
Name:LOZANO, ROLANDO (MD)
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:
Last Name:LOZANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 DILLMONT DR SUITE 100
Mailing Address - Street 2:CENTRAL OHIO PEDIATRICS ENDOCRINOLOGY AND DIABETES SERV
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235
Mailing Address - Country:US
Mailing Address - Phone:614-839-3040
Mailing Address - Fax:
Practice Address - Street 1:55 DILLMONT DR STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-6458
Practice Address - Country:US
Practice Address - Phone:614-839-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL24322080P0205X
OH5061716L2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101030802OtherCIDC
TX101030801Medicaid
TX101030802OtherCIDC
TX370017860Medicare PIN