MEDICARE: DR. IGNACIO LOPEZ-MERINO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	ME0049078	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265466106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IGNACIO LOPEZ-MERINO MD

Provider Business Mailing Address
First Line	:	7050 NW 4TH ST
Second Line	:	#304
City	:	PLANTATION
State	:	FL
Zip	:	33317-2247
Country	:	US
Telephone Number	:	954-791-4774
Fax Number	:	954-791-2405

Provider Business Practice Location Address
First Line	:	7050 NW 4TH ST
Second Line	:	#304
City	:	PLANTATION
State	:	FL
Zip	:	33317-2247
Country	:	US
Telephone Number	:	954-791-4774
Fax Number	:	954-791-2405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	08/03/2010

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