Provider Demographics
NPI:1407136971
Name:FERNANDEZ LOPEZ, ARTURO (PAC)
Entity Type:Individual
Prefix:MR
First Name:ARTURO
Middle Name:
Last Name:FERNANDEZ LOPEZ
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 NW 87TH AVE STE 101-102
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2654
Mailing Address - Country:US
Mailing Address - Phone:786-506-3551
Mailing Address - Fax:
Practice Address - Street 1:2000 NW 87TH AVE STE 101-102
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2654
Practice Address - Country:US
Practice Address - Phone:305-189-1387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106113363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant