Provider Demographics
NPI:1184998056
Name:LOPEZ GARCIA, EDUARDO FRANCISCO
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:FRANCISCO
Last Name:LOPEZ GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 E 1ST ST
Mailing Address - Street 2:135 E FIRST STREET
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4609
Mailing Address - Country:US
Mailing Address - Phone:305-308-6478
Mailing Address - Fax:
Practice Address - Street 1:135 E FIRST STREET
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805
Practice Address - Country:US
Practice Address - Phone:305-308-6478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL112172207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine