Individual
MR. CARLOS J LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2221 N HIMES AVE STE A, TAMPA, FL 33607-3139
(813) 877-9870
(813) 877-9869
Mailing address
4711 W WATERS AVE APT 209, TAMPA, FL 33614-1421
(305) 910-9832
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA57224
FL
Other
Enumeration date
12/22/2009
Last updated
01/25/2011
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