Organization
EXPERIONTECH, LLC
Active
Organization
EXPERIONTECH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL LOPEZ SA-C (PROVIDER)
(407) 480-0295
Entity
Organization
Contact information
Practice address
16756 ABBEY HILL CT, CLERMONT, FL 34711-6353
(407) 480-0295
Mailing address
16756 ABBEY HILL CT, CLERMONT, FL 34711-6353
(407) 480-0295
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
18324
FL
Other
Enumeration date
07/12/2018
Last updated
12/16/2023
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