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General NPI Number Information
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NPI Number | 1871526467
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Entity Type | Organization
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Legal Business Name | FERNANDO M LOPEZ-IVERN MD INC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 9980 CENTRAL PARK BLVD N SUITE 116
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City | BOCA RATON
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State | FL
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Zip | 33428-1762
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Country | US
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Telephone | 561-893-0651
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Fax | 561-893-0655
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Provider Business Mailing Address
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Address Line | 9980 CENTRAL PARK BLVD N STE 116
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City | BOCA RATON
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State | FL
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Zip | 33428-1703
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Country | US
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Telephone | 561-448-1880
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Fax | 561-893-0655
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Authorized Official
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Title or Position | OWNER
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Name | FERNANDO M LOPEZ
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Credential | M.D.
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Telephone | 561-893-0651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME 37131
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License Number State | FL
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