Healthcare Provider Details

I. General information

NPI: 1881512879
Provider Name (Legal Business Name): IGNACIO LOPEZ-CASTRO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 ALHAMBRA CIR STE A
CORAL GABLES FL
33134-5003
US

IV. Provider business mailing address

8400 OLD CUTLER RD
CORAL GABLES FL
33143-6216
US

V. Phone/Fax

Practice location:
  • Phone: 786-245-7001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN31801
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: