Provider Demographics
NPI:1184843393
Name:TEAM LOPEZ CHIROPRACTIC INC
Entity Type:Organization
Organization Name:TEAM LOPEZ CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NASLY
Authorized Official - Middle Name:MENENDEZ
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:D,C
Authorized Official - Phone:407-654-9888
Mailing Address - Street 1:15497 STONEYBROOK WEST PKWY
Mailing Address - Street 2:SUITE 180
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4770
Mailing Address - Country:US
Mailing Address - Phone:407-654-9888
Mailing Address - Fax:407-654-9886
Practice Address - Street 1:15497 STONEYBROOK WEST PKWY
Practice Address - Street 2:SUITE 180
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4770
Practice Address - Country:US
Practice Address - Phone:407-654-9888
Practice Address - Fax:407-654-9886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty