Individual
DANIEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
11416 CRESTLAKE VILLAGE DR, RIVERVIEW, FL 33568
(407) 803-2838
Mailing address
11416 CRESTLAKE VILLAGE DR, RIVERVIEW, FL 33569-2940
(407) 803-2838
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS55669
FL
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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