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Individual

ALEXANDER LOPEZ JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
440 SAWGRASS CORPORATE PKWY STE 106, SUNRISE, FL 33325-6236
(954) 745-1112
(954) 745-1120
Mailing address
440 SAWGRASS CORPORATE PKWY STE 106, SUNRISE, FL 33325-6236
(954) 745-1112
(954) 745-1120

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
19-79734
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
EAHCA013Z
FL
Enumeration date
09/24/2018
Last updated
04/04/2019
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