Lopez, Rafael

Lopez, Rafael is an individual health care provider with primary practice located at 2180 W 1St St Suite 202, Fort Myers FL 33901-3222. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Lopez, Rafael can be contacted via phone (239) 332-8009.

Contact Information

Primary practice address
2180 W 1St St Suite 202 Fort Myers FL 33901-3222
Phone: (239) 332-8009
Fax: (239) 332-4977
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X ME69037 Florida
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME69037 Virginia
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME69037 Florida

Profile Details

NPI number 1457491714
LBN Legal business name Lopez, Rafael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2007
Last updated Jan 2nd, 2018 - about 7 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 1457491714 NPPES
Florida MEDICAID 251555500

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