Individual
AGUSTIN RODOLFO LOPEZ LEIROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1631 DEL PRADO BLVD S STE 300, CAPE CORAL, FL 33990-6740
(786) 577-2018
(786) 957-5158
Mailing address
4102 NW 39TH ST, CAPE CORAL, FL 33993-7853
(786) 577-2018
(786) 957-5158
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9574671
FL
183500000X
Pharmacist
PS47176
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN11023966
FL
Other
Enumeration date
05/01/2013
Last updated
06/19/2026
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