Lopez, Eustorgio A.

Lopez, Eustorgio A. is an individual health care provider with primary practice located at 3200 S University Dr , Davie FL 33328-2018. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Lopez, Eustorgio A. can be contacted via phone (954) 262-7153.

Contact Information

Primary practice address
3200 S University Dr Davie FL 33328-2018
Phone: (954) 262-7153
Fax: (954) 262-1793
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DN 13112 Florida
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X ME74506 Florida

Profile Details

NPI number 1730145061
LBN Legal business name Lopez, Eustorgio A.
Credentials M.D., D.D.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Jul 9th, 2023 - about 2 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 1730145061 NPPES
Florida MEDICAID 015641700
Florida MEDICAID 2686961-00

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