Provider Demographics
NPI:1932436441
Name:LOPEZ SANO MEDICAL SERVICES, INC.
Entity type:Organization
Organization Name:LOPEZ SANO MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-592-0090
Mailing Address - Street 1:9590 NW 25TH ST # 101
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1402
Mailing Address - Country:US
Mailing Address - Phone:305-592-0090
Mailing Address - Fax:305-592-6363
Practice Address - Street 1:9590 NW 25TH ST # 101
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1402
Practice Address - Country:US
Practice Address - Phone:305-592-0090
Practice Address - Fax:305-592-6363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center