Provider Demographics
NPI:1831152958
Name:LOZANO, MARIA DE LA LUZ (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA DE LA LUZ
Middle Name:
Last Name:LOZANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16600 W SPRAGUE RD
Mailing Address - Street 2:SUITE 80
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-6318
Mailing Address - Country:US
Mailing Address - Phone:440-826-0500
Mailing Address - Fax:440-826-0501
Practice Address - Street 1:16600 W SPRAGUE RD
Practice Address - Street 2:SUITE 80
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-6318
Practice Address - Country:US
Practice Address - Phone:440-826-0500
Practice Address - Fax:440-826-0501
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.046596207QA0505X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000359249OtherANTHEM
OH0498117Medicaid
OHN371376OtherWELLCARE
WV3810016408Medicaid
WV3810016408Medicaid
OH0498117Medicaid
OHH094030Medicare PIN
OHN371376OtherWELLCARE
OH4282193Medicare PIN
OHLO4024039Medicare PIN