| Evelyn Lopez-brignoni Md Pa | |
|
299 Alhambra Cir Suite 218 Coral Gables FL 33134-5106 | |
| (305) 670-1411 | |
| (305) 670-2811 |
| Full Name | Evelyn Lopez-brignoni Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 299 Alhambra Cir, Coral Gables, Florida |
| Authorized Official Name and Position | Evelyn Lopez Brignoni (OWNER) |
| Authorized Official Contact | 3056701411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evelyn Lopez-brignoni Md Pa 299 Alhambra Cir Suite 218 Coral Gables FL 33134-5106 Ph: (305) 670-1411 | Evelyn Lopez-brignoni Md Pa 299 Alhambra Cir Suite 218 Coral Gables FL 33134-5106 Ph: (305) 670-1411 |
| NPI Number | 1487062451 |
|---|---|
| Provider Enumeration Date | 07/23/2014 |
| Last Update Date | 05/24/2023 |
| Certification Date | 05/24/2023 |
| Medicare PECOS PAC ID | 6406146604 |
|---|---|
| Medicare Enrollment ID | O20160531001784 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487062451 | NPI | - | NPPES |
| 008280 | Other | FL | BLUE CROSS BLUE SHIELD OF FLORIDA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME0054458 (Florida) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | ME0054458 (Florida) | Secondary |
| Provider Name | Evelyn Lopez-brignoni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306060256 PECOS PAC ID: 0840286795 Enrollment ID: I20040424000070 |
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