Provider Demographics
NPI:1164509501
Name:LOZANO, NORAH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NORAH
Middle Name:
Last Name:LOZANO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:NORAH
Other - Middle Name:
Other - Last Name:FEREDA LOZANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:4960 127TH TRAIL NORTH
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411
Mailing Address - Country:US
Mailing Address - Phone:561-333-8947
Mailing Address - Fax:
Practice Address - Street 1:4360 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:561-616-3360
Practice Address - Fax:561-616-4320
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29414183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21560100Medicaid
FL21560100Medicaid