Provider Demographics
NPI:1922389105
Name:BRENELLY LOZADA-CRUZ, M.D., LLC
Entity Type:Organization
Organization Name:BRENELLY LOZADA-CRUZ, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOZADA-CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-594-9824
Mailing Address - Street 1:6405 N FEDERAL HWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1412
Mailing Address - Country:US
Mailing Address - Phone:954-594-9824
Mailing Address - Fax:
Practice Address - Street 1:2300 N COMMERCE PKWY
Practice Address - Street 2:SUITE 321
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3254
Practice Address - Country:US
Practice Address - Phone:954-594-9824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty