Provider Demographics
NPI:1982714556
Name:LOPEZ-URIZAR, GLADYS ISABEL (MD)
Entity Type:Individual
Prefix:MRS
First Name:GLADYS
Middle Name:ISABEL
Last Name:LOPEZ-URIZAR
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 1:9299 SW 152ND STREET
Mailing Address - Street 2:#206
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157
Mailing Address - Country:US
Mailing Address - Phone:305-232-0505
Mailing Address - Fax:305-254-2500
Practice Address - Street 1:9299 SW 152ND STREET
Practice Address - Street 2:#206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157
Practice Address - Country:US
Practice Address - Phone:305-232-0505
Practice Address - Fax:305-254-2500
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38009208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2444OtherCIGNA
FL95644OtherBC & BS
FL95644OtherBC & BS