Provider Demographics
NPI:1750693867
Name:GADEA LOPEZ, MERCEDES (MD)
Entity type:Individual
Prefix:DR
First Name:MERCEDES
Middle Name:
Last Name:GADEA 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 1:421 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-4442
Mailing Address - Country:US
Mailing Address - Phone:561-275-1155
Mailing Address - Fax:561-275-1156
Practice Address - Street 1:421 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-4442
Practice Address - Country:US
Practice Address - Phone:561-275-1155
Practice Address - Fax:561-275-1156
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.056685208000000X
FLME115382208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics