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General NPI Number Information
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NPI Number | 1053831651
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Entity Type | Individual
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Provider Name | PAOLA MARCELA AMAYA DE LOPEZ MD
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Gender | Female
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Dates
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Enumeration Date | 06/23/2017
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 3333 BURNET AVE ML 4002
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City | CINCINNATI
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State | OH
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Zip | 45229-2545
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Country | US
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Telephone | 513-636-4611
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Fax | 513-636-3800
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVE ML 4002
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City | CINCINNATI
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State | OH
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Zip | 45229-2545
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Country | US
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Telephone | 513-636-4611
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Fax | 513-636-3800
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35.148627
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 35.148627
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License Number State | OH
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