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Organization

FEDERAL BUREAU OF PRISONS

Active
Parent organization
DEPARTMENT OF JUSTICE
Organization subpart
Yes

Provider details

NPI number
Legal business name
DEPARTMENT OF JUSTICE
Authorized official
DR. HECTOR LOPEZ MD (CLINICAL DIRECTOR)
(352) 689-7332
Entity
Organization

Contact information

Practice address
2801 FALCON RDG, CLERMONT, FL 34711-5892
(352) 243-8998
Mailing address
2801 FALCON RDG, CLERMONT, FL 34711-5892
(352) 243-8998

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
133531-1
NY

Other

Enumeration date
10/19/2015
Last updated
10/19/2015
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