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General NPI Number Information
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NPI Number | 1407182728
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Entity Type | Organization
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Legal Business Name | ENDOCRINE MEDICAL SERVICES, PA
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Dates
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Enumeration Date | 10/21/2009
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 3650 NW 82ND AVE SUITE 406
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City | DORAL
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State | FL
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Zip | 33166-6658
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Country | US
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Telephone | 786-336-6401
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Fax | 786-336-0160
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Provider Business Mailing Address
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Address Line | 3650 NW 82ND AVE SUITE 406
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City | DORAL
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State | FL
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Zip | 33166-6658
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Country | US
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Telephone | 786-336-6401
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Fax | 786-336-0160
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID L. LOPEZ
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Credential | M.D.
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Telephone | 786-336-6401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | ME 76319
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License Number State | FL
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