Organization
COMPLETE SURGICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIDICE B LOPEZ P.A. (PRESIDENT)
(305) 528-0447
Entity
Organization
Contact information
Practice address
261 W 32ND ST, HIALEAH, FL 33012-5317
(305) 528-0447
(305) 463-6693
Mailing address
261 W 32ND ST, HIALEAH, FL 33012-5317
(305) 528-0447
(305) 463-6693
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 9104530
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y00XD
BC BS FL
FL
Enumeration date
11/16/2010
Last updated
11/16/2010
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