Provider Demographics
NPI:1043263460
Name:LOZANO MEDICAL SUPPLY INC.
Entity Type:Organization
Organization Name:LOZANO MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AUTHORIZED OFFICIAL
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LOZANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-818-3177
Mailing Address - Street 1:11117 OKEECHOBEE ROAD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4211
Mailing Address - Country:US
Mailing Address - Phone:305-818-3177
Mailing Address - Fax:305-818-3044
Practice Address - Street 1:11117 W OKEECHOBEE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4212
Practice Address - Country:US
Practice Address - Phone:305-818-3177
Practice Address - Fax:305-818-3044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING NUMBER332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies