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General NPI Number Information
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NPI Number | 1063916047
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Entity Type | Individual
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Provider Name | ANNE LOPEZ ASHOURI MD
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Gender | Female
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 2815 S SEACREST BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-7969
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Country | US
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Telephone | 561-737-7733
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Fax |
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Provider Business Mailing Address
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Address Line | 9331 GRAND PRIX LN
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-2783
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Country | US
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Telephone |
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 1014755
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License Number State | MA
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME154422
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License Number State | FL
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