Organization
MLL PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY LOPEZ (CEO)
(305) 520-9154
Entity
Organization
Contact information
Practice address
7031 SW 62ND AVE, SOUTH MIAMI, FL 33143-4701
(305) 520-9154
Mailing address
15476 NW 77TH CT # 113, MIAMI LAKES, FL 33016-5823
(305) 520-9154
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3849
FL
Other
Enumeration date
11/02/2016
Last updated
04/24/2019
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