# OPHELIE PRIMARY CARE PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ophelie Primary Care PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891375390
- **Authorized official:** OFELIA LOPEZ (MD/OWNER)
- **Authorized official phone:** (914) 815-7905

## Contact information

- **Practice address:** 5607 26TH ST W, BRADENTON, FL 34207-3516
- **Practice address phone:** (914) 815-7905
- **Mailing address:** 5607 26TH ST W, BRADENTON, FL 34207-3516
- **Mailing address phone:** (914) 815-7905

## Taxonomy

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

## Other

- **Enumeration date:** 04/09/2021
- **Last updated:** 04/12/2021