Doctor Name: | MARISA P LOPEZ |
NPI Number: | 1770538605 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | |
Business Practice Address: | 1625 Se 3rd Ave Ste 620 Fort Lauderdale, FL - 333162521 |
Business Phone Number: | 9546203307 |
Business Fax Number: | 9546203308 |
Mailing Address: | 1625 Se 3rd Ave, Ste 620 FORT LAUDERDALE |
State: | FL |
Postal Code: | 333162521 |
Phone Number: | 9546203307 |
Fax Number: | 9546203308 |
NPI Enumeration Date: | 05/22/2006 |
NPI Last Update Date: | 03/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |