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General NPI Number Information
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NPI Number | 1841430774
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Entity Type | Individual
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Provider Name | JOSE A LOPEZ RAYMAT ARNP,SAC
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Gender | Male
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 8000 GRAND CANAL DR
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City | MIAMI
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State | FL
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Zip | 33144-2150
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Country | US
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Telephone | 786-379-1204
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Fax |
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Provider Business Mailing Address
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Address Line | 8000 GRAND CANAL DR
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City | MIAMI
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State | FL
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Zip | 33144-2150
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Country | US
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Telephone | 786-379-1204
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 08194
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11030303
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License Number State | FL
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