Lopez, Jose Luis

Lopez, Jose Luis is an sole proprietor health care provider with primary practice located at 6459 Sw County Road 18 Unit 4 , Fort White FL 32038-3464. He recently has only one registered license in Transportation Services / Non-emergency Medical Transport (VAN), which is considered as his primary health care specialty. Lopez, Jose Luis can be contacted via phone (352) 474-9788.

Contact Information

Primary practice address
6459 Sw County Road 18 Unit 4 Fort White FL 32038-3464
Phone: (352) 474-9788
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Transportation Services / Non-emergency Medical Transport (VAN) 343900000X Florida

Profile Details

NPI number 1255895348
LBN Legal business name Lopez, Jose Luis
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 23rd, 2019
Last updated Jan 23rd, 2019 - about 6 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 1255895348 NPPES
Florida MEDICAID 474115030

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