Provider Demographics
NPI:1265466106
Name:LOPEZ-MERINO, IGNACIO (MD)
Entity Type:Individual
Prefix:DR
First Name:IGNACIO
Middle Name:
Last Name:LOPEZ-MERINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7050 NW 4TH ST
Mailing Address - Street 2:#304
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2247
Mailing Address - Country:US
Mailing Address - Phone:954-791-4774
Mailing Address - Fax:954-791-2405
Practice Address - Street 1:7050 NW 4TH ST
Practice Address - Street 2:#304
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2247
Practice Address - Country:US
Practice Address - Phone:954-791-4774
Practice Address - Fax:954-791-2405
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00490782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02810Medicare ID - Type Unspecified
D60911Medicare UPIN