Individual
JORGE M LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11413 SW 253RD ST, HOMESTEAD, FL 33032-6036
(786) 439-5989
Mailing address
11413 SW 253RD ST, HOMESTEAD, FL 33032-6036
(786) 439-5989
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
04/03/2018
Last updated
04/03/2018
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