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NPI Code Detail

MEDICARE: CAMILLE TERESE LOPEZ BCBA

MEDICARE: CAMILLE TERESE LOPEZ BCBA
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
1103K00000XBehavior Analyst1-18-30064FL

Other Identifiers

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

General Provider Information

NPI Number : 1659817294
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMILLE TERESE LOPEZ BCBA
Provider Business Mailing Address
First Line : 1321 SW 126TH PL
Second Line :
City : MIAMI
State : FL
Zip : 33184-2311
Country : US
Telephone Number : 305-213-2264
Fax Number :
Provider Business Practice Location Address
First Line : 657 SOUTH DR STE 403
Second Line :
City : MIAMI SPRINGS
State : FL
Zip : 33166-5926
Country : US
Telephone Number : 786-860-5161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2017
Last Update Date : 04/03/2023

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Directions to “ CAMILLE TERESE LOPEZ BCBA” Practice Location

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