Individual
JEFFREY LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17670 NW 78TH AVE STE 111, HIALEAH, FL 33015-3665
(786) 806-7987
Mailing address
17670 NW 78TH AVE STE 111, HIALEAH, FL 33015-3665
(786) 806-7987
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
FL
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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