Provider Demographics
NPI:1275763880
Name:LOPEZ, MARIA MILAGRO (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:MILAGRO
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 NW 1ST CT
Mailing Address - Street 2:APT #107
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2219
Mailing Address - Country:US
Mailing Address - Phone:954-257-8933
Mailing Address - Fax:954-533-1473
Practice Address - Street 1:7500 NW 1ST CT
Practice Address - Street 2:APT #107
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2248
Practice Address - Country:US
Practice Address - Phone:954-257-8933
Practice Address - Fax:954-533-1473
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist