Provider Demographics
NPI:1417227034
Name:LOZANO, MELISSA C
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:C
Last Name:LOZANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 SW HIGHWAY 200
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-9685
Mailing Address - Country:US
Mailing Address - Phone:352-861-1667
Mailing Address - Fax:
Practice Address - Street 1:8150 SW HIGHWAY 200
Practice Address - Street 2:SUITE 400
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-9685
Practice Address - Country:US
Practice Address - Phone:352-861-1667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9262983363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner