Individual
CAMILO E LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A
Contact information
Practice address
10445 SW 128TH TER, MIAMI, FL 33176-5540
(786) 290-3211
(305) 259-1931
Mailing address
10445 SW 128TH TER, MIAMI, FL 33176-5540
(305) 232-8234
(305) 259-1931
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9100817
FL
Other
Enumeration date
06/14/2006
Last updated
04/06/2016
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