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General NPI Number Information
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NPI Number | 1740969831
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Entity Type | Individual
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Provider Name | LUIS ALBERTO ROBLES LOPEZ
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Gender | Male
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Dates
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Enumeration Date | 07/14/2023
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 1095 NW 14TH TER FL 2
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City | MIAMI
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State | FL
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Zip | 33136-1060
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Country | US
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Telephone | 305-243-6751
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Fax |
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Provider Business Mailing Address
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Address Line | 1444 NW 14TH AVE APT 705
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City | MIAMI
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State | FL
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Zip | 33125-1688
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Country | US
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Telephone | 786-620-5892
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 38409
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 38409
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 38409
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License Number State | FL
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