| Elda M Lopez Llc | |
|
10661 N Kendall Dr Ste 227 Miami FL 33176-1556 | |
| (305) 598-8000 | |
| (305) 598-8019 |
| Full Name | Elda M Lopez Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 10661 N Kendall Dr Ste 227, Miami, Florida |
| Authorized Official Name and Position | Elda M Lopez (OWNER) |
| Authorized Official Contact | 3055988000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elda M Lopez Llc 10661 N Kendall Dr Ste 227 Miami FL 33176-1556 Ph: (305) 598-8000 | Elda M Lopez Llc 10661 N Kendall Dr Ste 227 Miami FL 33176-1556 Ph: (305) 598-8000 |
| NPI Number | 1477001204 |
|---|---|
| Provider Enumeration Date | 09/21/2016 |
| Last Update Date | 07/07/2023 |
| Certification Date | 07/07/2023 |
| Medicare PECOS PAC ID | 5193000495 |
|---|---|
| Medicare Enrollment ID | O20170329001766 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477001204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME86541 (Florida) | Primary |
| Provider Name | Elda M Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538141809 PECOS PAC ID: 2860448941 Enrollment ID: I20050323000131 |
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