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Individual

ADRIANA CECILIA LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
7516 NW 108TH PATH, DORAL, FL 33178-2250
(786) 253-7211
(866) 876-8278
Mailing address
7516 NW 108TH PATH, DORAL, FL 33178-2250
(786) 253-7211
(866) 876-8278

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT 11564
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
890189900
FL
Enumeration date
11/22/2006
Last updated
03/06/2013
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