Organization
L & W PEDIATRICS PA
Active
Other names
Pediatric Partners
Organization subpart
No
Provider details
NPI number
Authorized official
GERARDO LOPEZ MD (PHYSICIAN OWNER)
(941) 748-7500
Entity
Organization
Contact information
Practice address
4764 E STATE ROAD 64, BRADENTON, FL 34208-9058
(941) 748-7500
(941) 748-7509
Mailing address
4949 E STATE ROAD 64, PMB #139, BRADENTON, FL 34208-5530
(941) 748-7500
(941) 748-7509
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME57700
FL
208000000X
Pediatrics Physician
ME70521
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME57700
MEDICAL LICENSE DR LOPEZ
FL
01
—
ME70521
MEDICAL LICENSE DR WHITE
FL
Enumeration date
12/15/2006
Last updated
07/24/2008
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