Provider Demographics
NPI:1003605569
Name:LOPEZ LOPEZ, DAMARIS LAZARA
Entity type:Individual
Prefix:
First Name:DAMARIS
Middle Name:LAZARA
Last Name:LOPEZ LOPEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5307
Mailing Address - Country:US
Mailing Address - Phone:786-745-9403
Mailing Address - Fax:
Practice Address - Street 1:7301 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5307
Practice Address - Country:US
Practice Address - Phone:786-745-9403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI6102246Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology