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General NPI Number Information
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NPI Number | 1902006315
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Entity Type | Organization
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Legal Business Name | JC LOPEZ ESCOBAR MD PA
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 06/21/2016
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Provider Practice Location Address
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Address Line | 7000 SW 62ND AVE SUITE 300
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4716
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Country | US
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Telephone | 786-581-9116
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Fax | 786-592-2352
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Provider Business Mailing Address
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Address Line | 13168 SW 188TH ST
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City | MIAMI
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State | FL
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Zip | 33177-3002
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Country | US
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Telephone | 786-581-9116
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Fax | 786-592-2352
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSE C LOPEZ
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Credential | M.D.
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Telephone | 786-752-2270
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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 | ME55324
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License Number State | FL
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