Individual
LUIS ALBERTO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
17801 NW 52ND AVE, MIAMI GARDENS, FL 33055-3100
(786) 683-3916
Mailing address
15291 NW 60TH AVE, MIAMI LAKES, FL 33014-2458
(786) 683-3916
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA17368
FL
Other
Enumeration date
08/10/2020
Last updated
08/10/2020
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