Provider Demographics
NPI:1396213062
Name:LOPEZ TRUY, ADRIAN (ARNP)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:LOPEZ TRUY
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3769 NW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2622
Mailing Address - Country:US
Mailing Address - Phone:786-728-7216
Mailing Address - Fax:
Practice Address - Street 1:3769 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2622
Practice Address - Country:US
Practice Address - Phone:786-728-7216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-10
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000441363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00000000OtherNO INSURANCE AT THIS TIME