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Organization
ROSSANA LOPEZ MD PA
Active
Organization
ROSSANA LOPEZ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSSANA LOPEZ MD (OWNER)
(305) 836-1696
Entity
Organization
Contact information
Practice address
777 E 25TH ST, SUITE 516, HIALEAH, FL 33013-3825
(305) 836-1696
(305) 836-1698
Mailing address
3511 SW 100TH AVE, MIAMI, FL 33165-3846
(305) 836-1696
(305) 647-2150
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME64156
FL
2084P0800X
Psychiatry Physician
ME64156
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374037400
—
FL
Enumeration date
07/23/2012
Last updated
07/23/2012
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