Organization
LUIS J LOPEZ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUIS J LOPEZ MD (PHYSICIAN)
(813) 792-9752
Entity
Organization
Contact information
Practice address
4700 N. HABANA AVE, SUITE 701, TAMPA, FL 33614-7122
(813) 324-5888
(813) 374-8891
Mailing address
4700 N HABANA AVE STE 701, TAMPA, FL 33614-7122
(813) 324-5888
(813) 374-8891
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275993400
—
FL
01
—
ME93505
MEDICAL LICENSE
FL
Enumeration date
11/29/2007
Last updated
09/23/2024
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