Healthcare Provider Details

I. General information

NPI: 1609705235
Provider Name (Legal Business Name): MR. HUGO ALEXANDER LOPEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 NW 41ST ST STE 201
DORAL FL
33166-6202
US

IV. Provider business mailing address

1032 NW 87TH AVE APT 111
MIAMI FL
33172-3023
US

V. Phone/Fax

Practice location:
  • Phone: 305-541-5366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9665055
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: