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NPI Code Detail

MEDICARE: MR. PAUL JESSE LOPEZ

MEDICARE:  MR. PAUL JESSE LOPEZ
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
1224Z00000XOccupational Therapy Assistant11255FL

General Provider Information

NPI Number : 1467792432
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL JESSE LOPEZ
Provider Business Mailing Address
First Line : 1837 SAFFRON PLUM LANE
Second Line :
City : ORLANDO
State : FL
Zip : 32828
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1837 SAFFRON PLUM LN
Second Line :
City : ORLANDO
State : FL
Zip : 32828-7356
Country : US
Telephone Number : 407-721-2332
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2013
Last Update Date : 02/27/2013

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Directions to “ MR. PAUL JESSE LOPEZ ” Practice Location

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