Individual
ELDA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10661 N KENDALL DR STE 227, MIAMI, FL 33176-1556
(305) 598-8000
(305) 598-8019
Mailing address
10661 N KENDALL DR STE 227, MIAMI, FL 33176-1556
(305) 598-8000
(305) 598-8019
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME86541
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265870400
—
FL
01
—
62892C
MEDICARE PTAN
FL
Enumeration date
11/14/2005
Last updated
07/07/2023
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