Provider Demographics
NPI:1841551306
Name:LOZANO-RODRIGUEZ, JOSE RAFAEL
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:RAFAEL
Last Name:LOZANO-RODRIGUEZ
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 1:2651 W END RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7739
Mailing Address - Country:US
Mailing Address - Phone:561-762-2118
Mailing Address - Fax:
Practice Address - Street 1:2651 W END RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-7739
Practice Address - Country:US
Practice Address - Phone:561-762-2118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 1242235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist