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NPI Code Detail

MEDICARE: MR. MICHAEL LOPEZ

MEDICARE:  MR. MICHAEL  LOPEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247200000XOther Technician

General Provider Information

NPI Number : 1144207036
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL LOPEZ
Provider Business Mailing Address
First Line : 14750 NW 44TH CT
Second Line :
City : OPA LOCKA
State : FL
Zip : 33054-2304
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14750 NW 44TH CT
Second Line :
City : OPA LOCKA
State : FL
Zip : 33054-2304
Country : US
Telephone Number : 305-953-2266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 07/08/2007

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Directions to “ MR. MICHAEL LOPEZ ” Practice Location

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