Organization
ROBERT LOPEZ EXTENDER PLUS, LLC
Active
Organization
ROBERT LOPEZ EXTENDER PLUS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LOPEZ (OWNER)
(754) 800-7730
Entity
Organization
Contact information
Practice address
4451 NE 30TH TER, LIGHTHOUSE POINT, FL 33064-7229
(745) 800-7730
Mailing address
4451 NE 30TH TER, LIGHTHOUSE POINT, FL 33064-7229
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015779500
—
FL
Enumeration date
10/03/2016
Last updated
04/04/2025
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