Provider Demographics
NPI:1083711675
Name:LOPEZ, MARIA I (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:I
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8955 SW 87TH CT
Mailing Address - Street 2:STE 212
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2230
Mailing Address - Country:US
Mailing Address - Phone:305-412-1967
Mailing Address - Fax:305-412-1861
Practice Address - Street 1:8955 SW 87TH CT
Practice Address - Street 2:STE 212
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2230
Practice Address - Country:US
Practice Address - Phone:305-412-1967
Practice Address - Fax:305-412-1861
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0063157207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF66282Medicare UPIN
FL23338Medicare ID - Type Unspecified