Organization
FAMILY &PEDIATRIC MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILSON LOPEZ MD (PRESIDENT)
(305) 591-2988
Entity
Organization
Contact information
Practice address
3155 NW 82ND AVE STE 102, DORAL, FL 33122-1056
(305) 591-2988
(305) 591-2995
Mailing address
3155 NW 82ND AVE STE 102, DORAL, FL 33122-1056
(305) 591-2988
(305) 591-2995
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
Other
Enumeration date
08/27/2007
Last updated
06/30/2021
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