Provider Demographics
NPI:1750274734
Name:ROMAN LOPEZ, IRVING MANUEL
Entity type:Individual
Prefix:
First Name:IRVING
Middle Name:MANUEL
Last Name:ROMAN 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 1:6145 NW 7TH AVE APT 806
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-1245
Mailing Address - Country:US
Mailing Address - Phone:786-702-0224
Mailing Address - Fax:
Practice Address - Street 1:4215 SW 72ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4510
Practice Address - Country:US
Practice Address - Phone:305-377-3297
Practice Address - Fax:305-377-3854
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator