Individual
OLGA E LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
351 NW LE JEUNE RD, SUITE 403, MIAMI, FL 33126-5683
(305) 643-6447
(305) 541-5801
Mailing address
PO BOX 651555, MIAMI, FL 33265-1555
(305) 643-6447
(305) 541-5801
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME89435
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268880800
—
FL
01
—
47448
BLUE CROSS BLUE SHIELD NU
FL
01
—
ME89435
STATE LICENSE NUMBER
FL
Enumeration date
06/29/2006
Last updated
08/24/2023
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