Individual
MISS LIURKA V LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117-5167
(386) 231-3523
Mailing address
1501 KINGS HIGHWAY, ATTN: LEISA OGLESBY (RM. 1-201), SHREVEPORT, LA 71103-4228
(318) 675-4881
(318) 675-5069
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD.34761
AL
207ZC0006X
Clinical Pathology Physician
307775
LA
207ZP0101X
Anatomic Pathology Physician
Primary
ME139652
FL
Other
Enumeration date
09/04/2012
Last updated
11/20/2019
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