Individual
DR. IVAN ANTONIO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 NE 55TH BLVD, GAINESVILLE, FL 32641-2783
(352) 375-8484
(352) 264-8305
Mailing address
2839 SE COUNTRY CLUB RD, LAKE CITY, FL 32025-3802
(386) 752-4510
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME25786
FL
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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