Provider Demographics
NPI:1912776576
Name:LOPEZ, ROSANA SELECT (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSANA
Middle Name:SELECT
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 WEST AVE APT 830
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-5241
Mailing Address - Country:US
Mailing Address - Phone:787-467-4067
Mailing Address - Fax:
Practice Address - Street 1:1175 71ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3645
Practice Address - Country:US
Practice Address - Phone:786-442-3062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor