Lopez, Marisa P

Lopez, Marisa P is an sole proprietor health care provider with primary practice located at 1330 Se 4Th Ave Ste J , Fort Lauderdale FL 33316. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Lopez, Marisa P can be contacted via phone (954) 620-3307.

Contact Information

Primary practice address
1330 Se 4Th Ave Ste J Fort Lauderdale FL 33316
Phone: (954) 620-3307
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Allopathic & Osteopathic Physicians / Neurology 2084N0400X ME90785 Florida

Profile Details

NPI number 1770538605
LBN Legal business name Lopez, Marisa P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 22nd, 2006
Last updated Dec 18th, 2019 - about 7 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770538605 NPPES
Florida MEDICAID 269970200

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