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General NPI Number Information
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NPI Number | 1649064239
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Entity Type | Organization
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Legal Business Name | FLORIDAMD CLINIC PA
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 210 N WESTMONTE DR # 1001
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3311
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Country | US
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Telephone | 407-663-0401
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Fax | 407-606-8874
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Provider Business Mailing Address
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Address Line | 210 N WESTMONTE DR # 1001
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3311
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Country | US
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Telephone | 407-663-0401
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Fax | 407-606-8874
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Authorized Official
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Title or Position | OWNER
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Name | JOSE LOPEZ
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Credential | MD
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Telephone | 307-401-1027
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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 |
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License Number State |
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