Individual
INGRID LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8851 NW 119TH ST UNIT 4311, HIALEAH GARDENS, FL 33018-7913
(786) 970-6323
Mailing address
8851 NW 119TH ST UNIT 4311, HIALEAH GARDENS, FL 33018-7913
(786) 970-6323
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA63554
FL
Other
Enumeration date
06/22/2011
Last updated
06/22/2011
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