1710160783 NPI number — ARNALDO V. LOPEZ MD PA

Table of content: (NPI 1710160783)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710160783 NPI number — ARNALDO V. LOPEZ MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARNALDO V. LOPEZ MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710160783
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1545 SW 1ST ST
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33135-2163
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-541-3230
Provider Business Mailing Address Fax Number:
305-541-1650

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1545 SW 1ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33135-2136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-541-3230
Provider Business Practice Location Address Fax Number:
305-541-1650
Provider Enumeration Date:
12/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LOPEZ
Authorized Official First Name:
ARNALDO
Authorized Official Middle Name:
V
Authorized Official Title or Position:
MD PRESIDENT
Authorized Official Telephone Number:
305-541-3230

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  ME0024389 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 054864200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: FK839A . This is a "MEDICARE PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com