Individual
JORGE LOPEZ-CANINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15495 EAGLE NEST LN STE 245, MIAMI LAKES, FL 33014
(305) 330-6692
(305) 330-6686
Mailing address
PO BOX 653153, MIAMI, FL 33265-3153
(305) 330-6692
(305) 330-6686
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME123509
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015 521 800
—
FL
Enumeration date
10/16/2007
Last updated
03/23/2021
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