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General NPI Number Information
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NPI Number | 1194096164
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Entity Type | Organization
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Legal Business Name | LOPEZ SURGICAL INC.
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 2553 SOUTH FUNDY CIRCLE
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City | AURORA
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State | CO
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Zip | 80013
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Country | US
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Telephone | 303-947-8673
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Fax | 303-368-4238
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Provider Business Mailing Address
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Address Line | 2553 SOUTH FUNDY CIRCLE
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City | AURORA
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State | CO
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Zip | 80013
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Country | US
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Telephone | 303-947-8673
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Fax | 303-368-4238
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Authorized Official
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Title or Position | RNFA
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Name | DEBRA KAY LOPEZ
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Credential | BSN
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Telephone | 303-947-8673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 126572
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License Number State | CO
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