Individual
MR. ANTONIO JOSE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
719 85TH ST, MIAMI BEACH, FL 33141-1109
(786) 523-3208
Mailing address
719 85TH ST, MIAMI BEACH, FL 33141-1109
(786) 523-3208
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
TPPA562
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
270455892
NPI #
FL
Enumeration date
02/24/2010
Last updated
08/21/2023
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