| Jorge E Lopez Perez Md Pa | |
|
11750 Bird Rd Miami FL 33175-3530 | |
| (305) 223-3000 | |
| Not Available |
| Full Name | Jorge E Lopez Perez Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 11750 Bird Rd, Miami, Florida |
| Authorized Official Name and Position | Jorge E Lopez Perez (OWNER) |
| Authorized Official Contact | 7863857614 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jorge E Lopez Perez Md Pa 8255 Sw 72nd Ct Unit 429 Miami FL 33143-4262 Ph: () - | Jorge E Lopez Perez Md Pa 11750 Bird Rd Miami FL 33175-3530 Ph: (305) 223-3000 |
| NPI Number | 1215672043 |
|---|---|
| Provider Enumeration Date | 05/05/2022 |
| Last Update Date | 05/05/2022 |
| Medicare PECOS PAC ID | 7517348345 |
|---|---|
| Medicare Enrollment ID | O20220725002782 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215672043 | NPI | - | NPPES |
| 110229100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jorge Edmundo Lopez Perez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235622549 PECOS PAC ID: 7416358627 Enrollment ID: I20210625000723 |
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