Healthcare Provider Details

I. General information

NPI: 1295750073
Provider Name (Legal Business Name): ARMANDO J. LOPEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 45TH ST
WEST PALM BEACH FL
33407-2361
US

IV. Provider business mailing address

2450 WESTMONT PL
ROYAL PALM BEACH FL
33411-6140
US

V. Phone/Fax

Practice location:
  • Phone: 561-514-5300
  • Fax:
Mailing address:
  • Phone: 561-790-4968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberO06300
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: