Healthcare Provider Details

I. General information

NPI: 1801272505
Provider Name (Legal Business Name): CLAUDIA MARIA LOPEZ RODRIGUEZ M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14254 DR MARTIN LUTHER KING JR BLVD
DOVER FL
33527-4414
US

IV. Provider business mailing address

14254 DR MARTIN LUTHER KING JR BLVD
DOVER FL
33527-4414
US

V. Phone/Fax

Practice location:
  • Phone: 813-349-7700
  • Fax: 866-290-9304
Mailing address:
  • Phone: 813-349-7700
  • Fax: 866-290-9304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number294535
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME136782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: