| Lopez Mental Health Llc | |
|
12610 Henderson Rd Ste 4, Ste 1003 Tampa FL 33625-6548 | |
| (813) 279-1364 | |
| Not Available |
| Full Name | Lopez Mental Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 12610 Henderson Rd Ste 4, Ste 1003, Tampa, Florida |
| Authorized Official Name and Position | Edgar O Lopez De Castro (OWNER) |
| Authorized Official Contact | 8132791364 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lopez Mental Health Llc 12610 Henderson Rd Ste 4, Ste 1003 Tampa FL 33625-6548 Ph: () - | Lopez Mental Health Llc 12610 Henderson Rd Ste 4, Ste 1003 Tampa FL 33625-6548 Ph: (813) 279-1364 |
| NPI Number | 1295501278 |
|---|---|
| Provider Enumeration Date | 11/30/2023 |
| Last Update Date | 11/30/2023 |
| Certification Date | 11/30/2023 |
| Medicare PECOS PAC ID | 4789036203 |
|---|---|
| Medicare Enrollment ID | O20240122000035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295501278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Edgar O Lopez De Castro Delgado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316500762 PECOS PAC ID: 6800284084 Enrollment ID: I20230913000390 |
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