| Camilo E. Lopez PA | |
|
10445 Sw 128th Ter Miami FL 33176-5540 | |
| (305) 232-8234 | |
| Not Available |
| Full Name | Camilo E. Lopez PA |
|---|---|
| Speciality | General Practice |
| Location | 10445 Sw 128th Ter, Miami, Florida |
| Authorized Official Name and Position | Camilo E Lopez (OWNER) |
| Authorized Official Contact | 7862903211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Camilo E. Lopez PA 10445 Sw 128th Ter Miami FL 33176-5540 Ph: (786) 290-3211 | Camilo E. Lopez PA 10445 Sw 128th Ter Miami FL 33176-5540 Ph: (305) 232-8234 |
| NPI Number | 1760674501 |
|---|---|
| Provider Enumeration Date | 08/15/2007 |
| Last Update Date | 07/15/2010 |
| Medicare PECOS PAC ID | 0749437481 |
|---|---|
| Medicare Enrollment ID | O20120830000782 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760674501 | NPI | - | NPPES |
| 291032200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Camilo E. Lopez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043253479 PECOS PAC ID: 1254588767 Enrollment ID: I20120905000453 |
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