Provider Demographics
NPI:1730140468
Name:LOZADA MUNOZ, LUIS RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:RAMON
Last Name:LOZADA MUNOZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 366527
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-6527
Mailing Address - Country:US
Mailing Address - Phone:787-765-7320
Mailing Address - Fax:787-765-7656
Practice Address - Street 1:300 AVE DOMENECH
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3509
Practice Address - Country:US
Practice Address - Phone:787-765-7320
Practice Address - Fax:787-765-3230
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12108207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG56992Medicare UPIN
PR89089Medicare PIN