Individual
MR. JULIO B LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
315 S W C OWENS AVE, CLEWISTON, FL 33440-3637
(863) 983-7813
(863) 983-9604
Mailing address
4450 S TIFFANY DR, WEST PALM BEACH, FL 33407-3241
(561) 844-9443
(561) 844-1013
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2290
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290257500
—
FL
Enumeration date
03/20/2006
Last updated
04/22/2009
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