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Organization

ID PROFESSIONALS OF SOUTH FLORIDA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARIO R. LOPEZ M.D. (PRESIDENT)
(954) 495-5102
Entity
Organization

Contact information

Practice address
1790 W 49TH ST, SUITE 400-9, HIALEAH, FL 33012-2992
(305) 698-5997
(305) 698-5998
Mailing address
PO BOX 371082, MIAMI, FL 33137-1082
(305) 698-5997
(305) 698-5998

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME75291
FL

Other

Enumeration date
06/01/2006
Last updated
01/22/2009
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