Provider Demographics
NPI:1952114241
Name:LOPEZ, JOSE ARTURO (PA-C)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:ARTURO
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14253 SW 163RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1810
Mailing Address - Country:US
Mailing Address - Phone:786-651-4132
Mailing Address - Fax:
Practice Address - Street 1:14253 SW 163RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1810
Practice Address - Country:US
Practice Address - Phone:786-651-4132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant