Provider Demographics
NPI:1437580727
Name:LOPES, JOAQUIM AMADOR
Entity Type:Individual
Prefix:MR
First Name:JOAQUIM
Middle Name:AMADOR
Last Name:LOPES
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JACK
Other - Middle Name:
Other - Last Name:LOPES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RT (R) (MR) ARRT
Mailing Address - Street 1:7305 N MILITARY TRL
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-7417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7305 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-7417
Practice Address - Country:US
Practice Address - Phone:561-422-7734
Practice Address - Fax:561-422-8289
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCRT 560532471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging