Provider Demographics
NPI:1629070339
Name:LOPES, ARQUIMEDES (RPT)
Entity Type:Individual
Prefix:MR
First Name:ARQUIMEDES
Middle Name:
Last Name:LOPES
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MIAMI AVE
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-3519
Mailing Address - Country:US
Mailing Address - Phone:321-506-4830
Mailing Address - Fax:321-220-0566
Practice Address - Street 1:200 MIAMI AVE
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-3519
Practice Address - Country:US
Practice Address - Phone:321-506-4830
Practice Address - Fax:321-220-0566
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT00010923208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY5323AMedicare ID - Type UnspecifiedPHYSICAL THERAPIST