MEDICARE: ANGEL F. LOPEZ D.M.D., P.A.

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	1223G0001X	General Practice Dentistry	DN16565	FL

General Provider Information

NPI Number	:	1750585188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL F. LOPEZ D.M.D., P.A.

Provider Business Mailing Address
First Line	:	95 ALAFAYA WOODS BLVD
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-6235
Country	:	US
Telephone Number	:	407-977-9888
Fax Number	:	888-543-6075

Provider Business Practice Location Address
First Line	:	425 TUTUS PT
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-8406
Country	:	US
Telephone Number	:	407-977-8888
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANGEL F LOPEZ
Credential	:
Telephone Number	:	407-977-9888

Provider Enumeration Date	:	06/11/2007
Last Update Date	:	08/13/2024

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