Provider Demographics
NPI:1134125461
Name:LOZMAN, PHILIP RANDALL (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:RANDALL
Last Name:LOZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 402125
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-0125
Mailing Address - Country:US
Mailing Address - Phone:305-674-5956
Mailing Address - Fax:305-674-5958
Practice Address - Street 1:4701 MERIDIAN AVE
Practice Address - Street 2:STE 601 ADAMS BLDG
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2910
Practice Address - Country:US
Practice Address - Phone:305-674-5956
Practice Address - Fax:305-674-5958
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058688207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G14872Medicare UPIN
26945Medicare ID - Type Unspecified