Provider Demographics
NPI:1407883267
Name:LOZANO, JAIME (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:
Last Name:LOZANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20405 OLD CUTLER RD
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1833
Mailing Address - Country:US
Mailing Address - Phone:305-271-1515
Mailing Address - Fax:305-271-1115
Practice Address - Street 1:20405 OLD CUTLER RD
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1833
Practice Address - Country:US
Practice Address - Phone:305-946-1030
Practice Address - Fax:305-946-1029
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME445222085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012967OtherAVMED
FL0442435OtherCIGNA
FL23391AOtherCAREPLUS
FL36 01291OtherUNITED
FL18806OtherWELLCARE
FL18806OtherHEALTH EASE
FLFV 17 222846 01OtherAMERIGROUP
FL1627391OtherFIRST HEALTH
FL650859562OtherHUMANA
FL9415OtherNHP
FL049404600Medicaid
FL3286249OtherAETNA
FLD78998Medicare UPIN
FL049404600Medicaid