Healthcare Provider Details

I. General information

NPI: 1851493191
Provider Name (Legal Business Name): LARRY MARKEL LOPEZ PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SOUTH NEWELL DR. HPNP BLDG 212; ROOM 3309
GAINESVILLE FL
32611
US

IV. Provider business mailing address

2611 NW 31ST TER
GAINESVILLE FL
32605-2732
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-6234
  • Fax: 352-273-6242
Mailing address:
  • Phone: 352-373-9768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number12290
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number006725
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: