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General NPI Number Information
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NPI Number | 1871015693
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Entity Type | Organization
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Legal Business Name | REMBERTO LOPEZ MD PA
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Dates
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Enumeration Date | 07/13/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 814 SW PINE ISLAND RD STE 306
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City | CAPE CORAL
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State | FL
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Zip | 33991-1943
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Country | US
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Telephone | 239-984-5610
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Fax | 239-984-5563
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Provider Business Mailing Address
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Address Line | 814 SW PINE ISLAND RD STE 306
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City | CAPE CORAL
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State | FL
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Zip | 33991-1943
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Country | US
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Telephone | 239-984-5610
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Fax | 239-984-5563
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. REMBERTO LOPEZ
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Credential | MD
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Telephone | 239-984-5610
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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 | ME120649
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License Number State | FL
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