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General NPI Number Information
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NPI Number | 1558392134
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Entity Type | Individual
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Provider Name | REMBERTO LOPEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 949 CHIQUITA BLVD S
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City | CAPE CORAL
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State | FL
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Zip | 33991-2143
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Country | US
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Telephone | 239-984-5610
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Fax | 239-984-5563
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Provider Business Mailing Address
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Address Line | 814 SW PINE ISLAND RD STE 306
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City | CAPE CORAL
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State | FL
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Zip | 33991-1943
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Country | US
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Telephone | 239-984-5610
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Fax | 239-984-5563
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | Q1206
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9102608
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License Number State | FL
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Taxonomy #3
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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 | BP10040024
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME120649
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License Number State | FL
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