Provider Demographics
NPI:1558366732
Name:LOZANO, GILBERTO A (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:A
Last Name:LOZANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:320 STATE ROAD 60 E STE 301
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-3702
Practice Address - Country:US
Practice Address - Phone:863-678-1400
Practice Address - Fax:863-678-1414
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84676207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264841500Medicaid
FLH61240Medicare UPIN
FL264841500Medicaid
FL15553YMedicare PIN