Individual
MARCOS ANTONIO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1490 NW 27TH AVE STE 130, MIAMI, FL 33125-2173
(305) 635-7710
(786) 621-7816
Mailing address
1490 NW 27TH AVE STE 130, MIAMI, FL 33125-2173
(305) 635-7710
(786) 621-7816
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9283150
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021904100
—
FL
Enumeration date
07/22/2016
Last updated
07/21/2022
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