Provider Demographics
NPI:1881625275
Name:PACHECO-LOZADA, ANA (LND)
Entity type:Individual
Prefix:MS
First Name:ANA
Middle Name:
Last Name:PACHECO-LOZADA
Suffix:
Gender:F
Credentials:LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB #87 PO BOX 70344
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:US
Mailing Address - Phone:787-421-0306
Mailing Address - Fax:787-773-8303
Practice Address - Street 1:EDIF. DECANATO DE ESTUDIANTES, CENTRO MEDICO DE PR
Practice Address - Street 2:PRIMER PISO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-8344
Practice Address - Country:US
Practice Address - Phone:787-773-8283
Practice Address - Fax:787-773-8303
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1132133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0057274Medicare ID - Type Unspecified