Provider Demographics
NPI:1578070025
Name:ABASCAL VALDES, LOZANIA LUCIA
Entity Type:Individual
Prefix:
First Name:LOZANIA
Middle Name:LUCIA
Last Name:ABASCAL VALDES
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 1:314 E ALTHEA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7404
Mailing Address - Country:US
Mailing Address - Phone:941-623-6034
Mailing Address - Fax:
Practice Address - Street 1:314 E ALTHEA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7404
Practice Address - Country:US
Practice Address - Phone:941-623-6034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-05
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
106S00000X
CO1-21-48836103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty