Provider Demographics
NPI:1629482476
Name:DIAZ LOZADA, LORNA ELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:LORNA
Middle Name:ELENA
Last Name:DIAZ LOZADA
Suffix:
Gender:F
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:R14-4 CALLE C
Mailing Address - Street 2:URB. TURABO GARDENS
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-5930
Mailing Address - Country:US
Mailing Address - Phone:787-475-5444
Mailing Address - Fax:
Practice Address - Street 1:AVE RAFAEL CORDERO FINAL ESQUINA TROCHE
Practice Address - Street 2:CORPORACION SANOS APARTADO 1025
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-1025
Practice Address - Country:US
Practice Address - Phone:787-745-0340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18783208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice