Individual
JOSE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3105 W WATERS AVE STE 304, TAMPA, FL 33614-2872
(813) 933-4506
Mailing address
3105 W WATERS AVE STE 304, TAMPA, FL 33614-2872
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA53981
FL
2471C3402X
Radiography Radiologic Technologist
Primary
BMO72850
FL
Other
Enumeration date
08/11/2008
Last updated
03/06/2009
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