Individual
CARLOS ERNESTO LOPEZ NOVOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
3250 MARY ST, COCONUT GROVE, FL 33133-5232
(305) 448-8100
(305) 448-8100
Mailing address
3250 MARY ST, COCONUT GROVE, FL 33133-5232
(305) 448-8100
(305) 448-8100
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT29823
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014108100
—
FL
Enumeration date
11/26/2014
Last updated
05/15/2015
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