Individual
EDGAR LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
311 NE 8TH ST STE 104, HOMESTEAD, FL 33030-4734
(305) 248-8600
(844) 272-8151
Mailing address
16884 SW 144TH PL, MIAMI, FL 33177-2012
(305) 607-4149
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 24429
FL
Other
Enumeration date
03/13/2016
Last updated
03/13/2016
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