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Organization

DR VIDAL N LOPEZ MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VIDAL N LOPEZ MD (PSYCHIATRIST)
(305) 480-5680
Entity
Organization

Contact information

Practice address
2682 SW 87TH AVE, MIAMI, FL 33165-2000
(305) 480-5680
(305) 480-5702
Mailing address
2682 SW 87TH AVE, MIAMI, FL 33165-2000
(305) 480-5680
(305) 480-5702

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH4844
FL
2084P0800X
Psychiatry Physician
Primary
ME14047
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
038015600
FL
Enumeration date
05/12/2017
Last updated
05/12/2017
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