Healthcare Provider Details

I. General information

NPI: 1962756577
Provider Name (Legal Business Name): EFRAIN LOPEZ ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2012
Last Update Date: 08/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 NW 132ND CT
MIAMI FL
33182-2251
US

IV. Provider business mailing address

14852 SW 22 TERRACE
MIAMI FL
33185
US

V. Phone/Fax

Practice location:
  • Phone: 786-266-0502
  • Fax:
Mailing address:
  • Phone: 786-266-0502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberARNP9295737
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9295737
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: