Physician Compare National (NPI:1558568816)

HEALTHCARE PROVIDER: MAYRA LOPEZ M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1558568816
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274622329
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130927000290
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LOPEZ
	Individual professional last name
Provider First Name	MAYRA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1983
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1010 DRUID RD E
	Group Practice or individual's line 1 address
City	CLEARWATER
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	337565606
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y