Provider Demographics
NPI:1275180176
Name:EDUARDO LOPEZ DEL CASTILLO, M.D, P.A.
Entity Type:Organization
Organization Name:EDUARDO LOPEZ DEL CASTILLO, M.D, P.A.
Other - Org Name:LDC PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOPEZ DEL CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-677-0227
Mailing Address - Street 1:2623 SW 147TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5622
Mailing Address - Country:US
Mailing Address - Phone:305-677-0227
Mailing Address - Fax:
Practice Address - Street 1:2623 SW 147TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5622
Practice Address - Country:US
Practice Address - Phone:305-677-0227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-25
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care