Individual
CARLOS LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4803 NW 7 ST # 409, MIAMI, FL 33216
(786) 380-8917
Mailing address
PO BOX 350343, MIAMI, FL 33135-0343
(786) 380-8917
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60779
FL
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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