# CAMILO E. LOPEZ PA

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

## Provider details

- **NPI number:** 1760674501
- **Authorized official:** CAMILO E LOPEZ PA (OWNER)
- **Authorized official phone:** (786) 290-3211

## Contact information

- **Practice address:** 10445 SW 128TH TER, MIAMI, FL 33176-5540
- **Practice address phone:** (305) 232-8234
- **Mailing address:** 10445 SW 128TH TER, MIAMI, FL 33176-5540
- **Mailing address phone:** (786) 290-3211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/15/2007
- **Last updated:** 07/15/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 291032200 | — | FL |