MEDICARE: ID PROFESSIONALS OF SOUTH FLORIDA LLC

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
1	207RI0200X	Infectious Disease Physician	ME75291	FL

General Provider Information

NPI Number	:	1174560619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ID PROFESSIONALS OF SOUTH FLORIDA LLC

Provider Business Mailing Address
First Line	:	PO BOX 371082
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137-1082
Country	:	US
Telephone Number	:	305-698-5997
Fax Number	:	305-698-5998

Provider Business Practice Location Address
First Line	:	1790 W 49TH ST
Second Line	:	SUITE 400-9
City	:	HIALEAH
State	:	FL
Zip	:	33012-2992
Country	:	US
Telephone Number	:	305-698-5997
Fax Number	:	305-698-5998

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARIO R. LOPEZ
Credential	:	M.D.
Telephone Number	:	954-495-5102

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	01/22/2009

Similar Medicare Providers

1174556674 — ARIAS ENTERPRISES CORP
Practice Location Address:

1790 W 49TH ST , STE 305-15
HIALEAH, FL
33012-2992

Practice Phone: 305-826-6262
Practice Fax: 305-826-6959

1356361224 — TELO MEDICAL SERVICES INC
Practice Location Address:

1790 W 49TH ST , SUITE 305-3
HIALEAH, FL
33012-2992

Practice Phone: 305-826-4888
Practice Fax: 305-480-9256

1609883792 — ERYS MEDICAL SUPPLYS CORP
Practice Location Address:

1790 W 49TH ST , 305-2
HIALEAH, FL
33012-2992

Practice Phone: 305-558-6551
Practice Fax: 305-558-6554

1386743896 — GILDA MARIA DE LA CALLE MD PA
Practice Location Address:

1790 W 49TH ST , SUITE 303
HIALEAH, FL
33012-2992

Practice Phone: 305-823-5730
Practice Fax: 305-823-5732

1457578700 — CAUSEY C. LEE, D.D.S., P.A.
Practice Location Address:

1790 W 49TH ST , SUITE 110
HIALEAH, FL
33012-2992

Practice Phone: 305-558-3384
Practice Fax: 305-828-5726

1750572319 — HELPINGHANDSATHOMESERVICESINC
Practice Location Address:

1790 W 49TH ST , SUITE 305-15
HIALEAH, FL
33012-2992

Practice Phone: 786-853-1944
Practice Fax: 305-825-6767

Directions to “ID PROFESSIONALS OF SOUTH FLORIDA LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.