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General NPI Number Information
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NPI Number | 1760674501
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Entity Type | Organization
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Legal Business Name | CAMILO E. LOPEZ PA
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 10445 SW 128TH TER
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City | MIAMI
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State | FL
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Zip | 33176-5540
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Country | US
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Telephone | 305-232-8234
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Fax |
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Provider Business Mailing Address
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Address Line | 10445 SW 128TH TER
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City | MIAMI
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State | FL
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Zip | 33176-5540
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Country | US
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Telephone | 786-290-3211
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAMILO E LOPEZ
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Credential | PA
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Telephone | 786-290-3211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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