Provider Demographics
NPI:1245289453
Name:LOZADA-CRUZ, BRENELLY (MD)
Entity type:Individual
Prefix:
First Name:BRENELLY
Middle Name:
Last Name:LOZADA-CRUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRENELLY
Other - Middle Name:
Other - Last Name:LOZADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2575 NORTHWINDS PKWY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2232
Mailing Address - Country:US
Mailing Address - Phone:678-501-2695
Mailing Address - Fax:678-495-5321
Practice Address - Street 1:1717 HIGH ST STE 1A
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-6300
Practice Address - Country:US
Practice Address - Phone:270-885-0570
Practice Address - Fax:270-885-0573
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP577207RH0003X
CODR.0054497207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2747740Medicaid
FL37012OtherBCBSFL
FL37012YMedicare PIN
FL152622Medicare UPIN