Lopez Diez, Manuel Enrique

Lopez Diez, Manuel Enrique is an individual health care provider with primary practice located at 4863 Palm Coast Pkwy Nw , Palm Coast FL 32137-3666. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Lopez Diez, Manuel Enrique can be contacted via phone (386) 222-7746.

Contact Information

Primary practice address
4863 Palm Coast Pkwy Nw Palm Coast FL 32137-3666
Phone: (386) 222-7746
Fax: (904) 212-1351
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 15704 Puerto Rico
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 4301087534 Michigan
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X ME 107153 Florida

Profile Details

NPI number 1144458100
LBN Legal business name Lopez Diez, Manuel Enrique
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2009
Last updated Dec 28th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144458100 NPPES
Florida MEDICAID 008263500

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