Individual
ASRIEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3211 W SITKA ST, TAMPA, FL 33614-2701
(813) 410-0828
(813) 999-4036
Mailing address
3211 W SITKA ST, TAMPA, FL 33614-2701
(813) 410-0828
(813) 999-4036
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
AL11512
FL
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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