Provider Demographics
NPI:1962235887
Name:LOPEZ, FRANCISCO ALEJANDRO
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:ALEJANDRO
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 FONTAINEBLEAU BLVD APT 704
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4681
Mailing Address - Country:US
Mailing Address - Phone:786-357-3567
Mailing Address - Fax:
Practice Address - Street 1:275 FONTAINEBLEAU BLVD APT 704
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4681
Practice Address - Country:US
Practice Address - Phone:786-357-3567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT24361914106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician