Individual
CARLOS LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 NORTHWEST 82ND AVE, PLANTATION, FL 33324
(954) 424-1766
Mailing address
PO BOX 17347, PLANTATION, FL 33318-7347
(954) 370-1053
(954) 370-1533
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME74839
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44330
BCBS
—
Enumeration date
10/02/2006
Last updated
03/06/2008
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