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General NPI Number Information
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NPI Number | 1538139936
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Entity Type | Individual
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Provider Name | MARIA O LOPEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 10111 FOREST HILL BLVD RM 268
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City | WELLINGTON
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State | FL
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Zip | 33414
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Country | US
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Telephone | 561-753-7571
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Fax | 561-753-7266
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Provider Business Mailing Address
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Address Line | 10111 FOREST HILL BLVD RM 268
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City | WELLINGTON
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State | FL
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Zip | 33414-6142
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Country | US
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Telephone | 561-753-7571
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Fax | 561-753-7266
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME62293
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0062293
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License Number State | FL
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