Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | 11004825 | FL |
N | 207R00000X | Internist | 11004825 | FL |
N | 111NI0900X | Internist | 11004825 | FL |
NPI | 1295368751 |
---|---|
Provider Name | Alejandra Lopez |
First Address | Hollywood, FL 33023-1967 |
Second Address | Fort Lauderdale, FL 33308-7111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2020 |
Last Update Date | 09/12/2021 |