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General NPI Number Information
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NPI Number | 1699841288
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Entity Type | Individual
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Provider Name | DANIEL WILLIAM LOPEZ CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 06/28/2017
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Provider Practice Location Address
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Address Line | 1 ATWELL RD
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City | COOPERSTOWN
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State | NY
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Zip | 13326-1301
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Country | US
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Telephone | 607-547-6924
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Fax |
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Provider Business Mailing Address
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Address Line | 10859 US HIGHWAY 98 W PERSONNAL MAILBOX 134
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550-7869
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Country | US
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Telephone | 207-232-5814
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 391082
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License Number State | NY
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