Organization
SERVICE AL LOPEZ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS E FONSECA LUGO (OWNER)
(786) 399-8295
Entity
Organization
Contact information
Practice address
900 W 49TH ST STE 560, HIALEAH, FL 33012-3442
(786) 989-7813
Mailing address
900 W 49TH ST STE 560, HIALEAH, FL 33012-3442
(786) 989-7813
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/30/2024
Last updated
01/02/2025
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