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Individual

MAXIMO LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
850 SW 2ND AVE UNIT 1702, MIAMI, FL 33130-3599
(786) 866-9727
Mailing address
850 SW 2ND AVE UNIT 1702, MIAMI, FL 33130-3599
(786) 866-9727

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
40187
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004438800
FL
Enumeration date
09/30/2009
Last updated
09/12/2018
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