Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO4025 | FL |
NPI | 1083065429 |
---|---|
Provider Name | Dr. Raymond Joseph Lopez |
First Address | Miami Beach, FL 33140-2948 |
Second Address | Miami Beach, FL 33140-2948 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2016 |
Last Update Date | 24/01/2020 |