Provider Demographics
NPI:1922553437
Name:LOZANO, JENRY
Entity Type:Individual
Prefix:
First Name:JENRY
Middle Name:
Last Name:LOZANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5085 NW 7TH ST APT 714
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3454
Mailing Address - Country:US
Mailing Address - Phone:786-413-6394
Mailing Address - Fax:
Practice Address - Street 1:5085 NW 7TH ST APT 714
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3454
Practice Address - Country:US
Practice Address - Phone:786-413-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst