MEDICARE: KIMBERLY MARIANA SANCHEZ 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
1	207R00000X	Internal Medicine Physician	ME175822	FL

General Provider Information

NPI Number	:	1578265393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY MARIANA SANCHEZ LOPEZ

Provider Business Mailing Address
First Line	:	18851 SW 25TH CT
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33029-2533
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11880 BIRD RD STE 101
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-3573
Country	:	US
Telephone Number	:	305-485-4677
Fax Number	:

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

Provider Enumeration Date	:	03/17/2023
Last Update Date	:	03/03/2026

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Directions to “ KIMBERLY MARIANA SANCHEZ LOPEZ ” Practice Location

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