Provider Demographics
NPI:1700961539
Name:LOPEZ, SAJID (MD)
Entity Type:Individual
Prefix:DR
First Name:SAJID
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7941 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-8000
Mailing Address - Country:US
Mailing Address - Phone:305-665-4698
Mailing Address - Fax:
Practice Address - Street 1:100 EDGEWATER DR
Practice Address - Street 2:209
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33133-6950
Practice Address - Country:US
Practice Address - Phone:718-334-3900
Practice Address - Fax:718-334-5958
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME971772084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU8989ZMedicare Oscar/Certification