MEDICARE: HERNAN ALBERTO LOPEZ MORRA M.D.

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	207RG0100X	Gastroenterology Physician	ME150776	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497945588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERNAN ALBERTO LOPEZ MORRA M.D.

Provider Business Mailing Address
First Line	:	258 S CHICKASAW TRL STE 300
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-3501
Country	:	US
Telephone Number	:	407-821-3674
Fax Number	:	407-821-3675

Provider Business Practice Location Address
First Line	:	258 S CHICKASAW TRL STE 300
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-3501
Country	:	US
Telephone Number	:	407-821-3674
Fax Number	:	407-821-3675

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

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	01/13/2023

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Directions to “ HERNAN ALBERTO LOPEZ MORRA M.D.” Practice Location

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