Individual
MICHAEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2708 NE 14TH ST, SUITE 5, POMPANO BEACH, FL 33062-3565
(888) 880-9270
Mailing address
1400 COLEMAN AVE, MERCER BOX 72807, MACON, GA 31207-0001
(706) 260-9570
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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