MEDICARE: ALAIN LOPEZ MS., CCC-SLP

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	235Z00000X	Speech-Language Pathologist	SA7194	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	:	1366409567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAIN LOPEZ MS., CCC-SLP

Provider Business Mailing Address
First Line	:	1620 5TH AVE
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33972-1530
Country	:	US
Telephone Number	:	239-265-2477
Fax Number	:	239-368-6705

Provider Business Practice Location Address
First Line	:	1620 5TH AVE
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33972-1530
Country	:	US
Telephone Number	:	239-265-2477
Fax Number	:	239-368-6705

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	07/08/2007

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