Provider Demographics
NPI:1407182728
Name:ENDOCRINE MEDICAL SERVICES, PA
Entity Type:Organization
Organization Name:ENDOCRINE MEDICAL SERVICES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-336-6401
Mailing Address - Street 1:3650 NW 82ND AVE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6658
Mailing Address - Country:US
Mailing Address - Phone:786-336-6401
Mailing Address - Fax:786-336-0160
Practice Address - Street 1:3650 NW 82ND AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6658
Practice Address - Country:US
Practice Address - Phone:786-336-6401
Practice Address - Fax:786-336-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 763192080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric EndocrinologyGroup - Single Specialty