Individual
RAFAEL LOPEZ SUBERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3229 TURRET BAY CT, KISSIMMEE, FL 34743-6063
(267) 945-1302
Mailing address
3229 TURRET BAY CT, KISSIMMEE, FL 34743-6063
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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