MEDICARE: CARLOS 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
1	227800000X	Certified Respiratory Therapist	TT11448	FL

General Provider Information

NPI Number	:	1487929642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS LOPEZ

Provider Business Mailing Address
First Line	:	1275 W 47TH PL
Second Line	:	SUITE 437
City	:	HIALEAH
State	:	FL
Zip	:	33012-3394
Country	:	US
Telephone Number	:	305-231-8227
Fax Number	:	786-522-9050

Provider Business Practice Location Address
First Line	:	1275 W 47TH PL
Second Line	:	SUITE 437
City	:	HIALEAH
State	:	FL
Zip	:	33012-3394
Country	:	US
Telephone Number	:	305-231-8227
Fax Number	:	786-522-9050

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

Provider Enumeration Date	:	03/20/2012
Last Update Date	:	03/20/2012

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Directions to “ CARLOS LOPEZ ” Practice Location

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