Eustorgio a Lopez LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

ME74506 Issued in FL

Legal business name

EUSTORGIO A LOPEZ LLC

Practice address

1548 NW 208TH Way
Pembroke Pines, FL 33029-2306

Phone

(786) 375-1449

Fax

(954) 337-0356

NPI assigned

Nov 1, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Eustorgio A Lopez, MD, DDS

Title

President

Phone

(786) 375-1449

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1023362811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1548 NW 208TH WAY",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292306",
            "telephone_number": "786-375-1449",
            "fax_number": "954-337-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1548 NW 208TH WAY",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292306",
            "telephone_number": "786-375-1449",
            "fax_number": "954-337-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUSTORGIO A LOPEZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-01",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "EUSTORGIO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-375-1449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "ME74506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valentina Etchevers Cristiani
• Georges Etienne, RT
• Nerlene Etienne, APRN
• Annelise Eugene
• Cynthia Eugene, APRN, FNP-BC
• Judith Evans
• Nicola Evans
• Shannon Michelle Evans, L.M.
• Evergreen Medical Center, PA
• Evernoble Incorporated

• Oral and Maxillofacial Surgery (Dentist) in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.