Individual
DR. JONATHAN LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2727 W DR MLK BLVD STE 570, TAMPA, FL 33607-6009
(813) 867-6200
Mailing address
2727 W DR MLK BLVD STE 570, TAMPA, FL 33607-6009
(813) 867-6200
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
ME133606
FL
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME133606
FL
207NS0135X
Procedural Dermatology Physician
ME133606
FL
Other
Enumeration date
06/25/2013
Last updated
08/09/2020
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