Provider Demographics
NPI:1033742440
Name:LOZANO, MARIA AURORA (PTA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:AURORA
Last Name:LOZANO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5336 SW 153RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4278
Mailing Address - Country:US
Mailing Address - Phone:786-340-0350
Mailing Address - Fax:
Practice Address - Street 1:311 NE 8TH ST STE 104
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4734
Practice Address - Country:US
Practice Address - Phone:305-248-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL29611225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant