MEDICARE: MS. ESTHER LOPEZ MS, CCC-SLP

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	235Z00000X	Speech-Language Pathologist	SA2947	FL

General Provider Information

NPI Number	:	1417288291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ESTHER LOPEZ MS, CCC-SLP

Provider Business Mailing Address
First Line	:	12783 SW 45TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4664
Country	:	US
Telephone Number	:	305-226-2012
Fax Number	:

Provider Business Practice Location Address
First Line	:	13831 SW 59TH ST
Second Line	:	STE 200
City	:	MIAMI
State	:	FL
Zip	:	33183-1159
Country	:	US
Telephone Number	:	305-226-2012
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2010
Last Update Date	:	01/29/2010

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Directions to “ MS. ESTHER LOPEZ MS, CCC-SLP” Practice Location

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