Individual
LUIS FERNANDO JOSE LOPEZ LA ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1270 PRINCE AVE, SUITE 102, ATHENS, GA 30606
(706) 475-7055
Mailing address
1270 PRINCE AVE, SUITE 102, ATHENS, GA 30606
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/08/2026
Last updated
06/08/2026
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