# MLL PODIATRY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629520911
- **Authorized official:** DR. MARY LOPEZ (CEO)
- **Authorized official phone:** (305) 520-9154

## Contact information

- **Practice address:** 7031 SW 62ND AVE, SOUTH MIAMI, FL 33143-4701
- **Practice address phone:** (305) 520-9154
- **Mailing address:** 15476 NW 77TH CT \# 113, MIAMI LAKES, FL 33016-5823
- **Mailing address phone:** (305) 520-9154

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO3849 | FL | Yes |

## Other

- **Enumeration date:** 11/02/2016
- **Last updated:** 04/24/2019