Provider Demographics
NPI:1952595308
Name:MARTINEZ-LOPEZ, LESTER (MD)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:
Last Name:MARTINEZ-LOPEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 DELAMERE CT
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-7281
Mailing Address - Country:US
Mailing Address - Phone:813-571-7273
Mailing Address - Fax:
Practice Address - Street 1:2307 DELAMERE CT
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-7281
Practice Address - Country:US
Practice Address - Phone:813-571-7273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79971207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine