Healthcare Provider Details

I. General information

NPI: 1598677155
Provider Name (Legal Business Name): ANDRES LOPEZ REYES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANDRES LOPEZ PHARMD

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S TAMIAMI TRL
SARASOTA FL
34239-3555
US

IV. Provider business mailing address

1700 S TAMIAMI TRL
SARASOTA FL
34239-3555
US

V. Phone/Fax

Practice location:
  • Phone: 941-917-2072
  • Fax:
Mailing address:
  • Phone: 941-917-2072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS71585
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: