Provider Demographics
NPI:1740491992
Name:LOZADA, CARMEN V
Entity type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:V
Last Name:LOZADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 CALLE 3
Mailing Address - Street 2:ARCOS EN SUCHVILLE APT 306
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-1679
Mailing Address - Country:US
Mailing Address - Phone:787-501-2351
Mailing Address - Fax:
Practice Address - Street 1:829 AVE SAN PATRICIO STE 1
Practice Address - Street 2:LAS LOMAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1313
Practice Address - Country:US
Practice Address - Phone:787-783-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1758183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist