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Individual
MR. ROBERTO LOPEZ
Active
Individual
MR. ROBERTO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA45169
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA45169
LICENCE NUMBER
FL
Enumeration date
05/12/2008
Last updated
05/12/2008
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