Provider Demographics
NPI:1770688251
Name:LOZANO, JOHN J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:LOZANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:14100 FIVAY RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7180
Mailing Address - Country:US
Mailing Address - Phone:727-869-2285
Mailing Address - Fax:727-863-9163
Practice Address - Street 1:14100 FIVAY RD
Practice Address - Street 2:SUITE 170
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7180
Practice Address - Country:US
Practice Address - Phone:727-869-2285
Practice Address - Fax:727-863-9163
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2008-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0029048207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59-2119550OtherTAX ID#
FL039987600Medicaid
FL039987600Medicaid
FLD84759Medicare UPIN