Provider Demographics
NPI:1164672762
Name:LEDEE LOZADA, LESLIE J (SLPD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:J
Last Name:LEDEE LOZADA
Suffix:
Gender:F
Credentials:SLPD, CCC-SLP
Other - Prefix:DR
Other - First Name:LESLIE
Other - Middle Name:J
Other - Last Name:LEDEE LOZADA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLPD, CCC-SLP
Mailing Address - Street 1:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-0176
Mailing Address - Country:US
Mailing Address - Phone:787-485-2676
Mailing Address - Fax:787-864-4627
Practice Address - Street 1:CALLE 3 E-11 URB JARDINES DE GUAMANI
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-485-2676
Practice Address - Fax:787-866-3377
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR828261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech