Organization
REYNALDO LOPEZ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REYNALDO LOPEZ MD (OWNER)
(787) 240-4737
Entity
Organization
Contact information
Practice address
15836 SW 61ST ST, MIAMI, FL 33193-3692
(787) 240-4737
Mailing address
15836 SW 61ST ST, MIAMI, FL 33193-3692
(787) 240-4737
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0919CMEDICO
COMMERCIAL PLANS
FL
Enumeration date
07/02/2013
Last updated
07/02/2013
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