Individual
MICHELLE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136
(305) 585-1111
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME157801
FL
Other
Enumeration date
06/06/2017
Last updated
08/05/2024
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