Lopez, Mario J

Lopez, Mario J is an individual health care provider with primary practice located at 1620 Tamiami Trail Suite 308, Port Charlotte FL 33948-4017. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Lopez, Mario J can be contacted via phone (941) 246-2482.

Contact Information

Primary practice address
1620 Tamiami Trail Suite 308 Port Charlotte FL 33948-4017
Phone: (941) 246-2482
Fax: (941) 979-9074
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MEOO50048 Florida
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X ME50048 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME50048 Florida

Profile Details

NPI number 1710990882
LBN Legal business name Lopez, Mario J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Oct 31st, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1710990882 NPPES
Florida MEDICAID 046520800

Popular Providers