1073505202

Everything you always wanted to know about LOPEZ D. JOHN CRNA but were afraid to ask.

LOPEZ D. JOHN CRNA

You can also download the this 1073505202 data report as csv | excel | json | xml
Provider Last Name Provider Middle Name Provider First Name Provider Credential
LOPEZ D. JOHN CRNA
Gender:
Male
Enumeration date:
2005-08-15
Last update date:
2016-10-13
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
Search for JOHN, LOPEZ in
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Identifiers

identifier description issuer state
430064443 Other RAILROAD MEDICARE FL
59084591 Other BLUE CROSS & BLUE SHIELD AL
009953310 Medicaid none AL
G1244 Other BLUECROSS & BLUESHIELD FL
303630800 Medicaid none FL

Taxonomies

Taxonomy State License Number Primary?
367500000X Nurse Anesthetist, Certified Registered NC 109696 N

Phone Numbers

Type Number
Mailing Address Fax Number 8504749060
Practice Location Address Fax Number 8504749060
Mailing Address Telephone Number 8504777042
Practice Location Address Telephone Number 8504777042

Addresses

Type Address City State Postal Country
Mailing Address 4901 GRANDE DR PENSACOLA FL 32504 FL
Practice Location Address 4901 GRANDE DR PENSACOLA FL 32504 FL

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4901 GRANDE DR FL PENSACOLA
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1295750917 DAVIS, LISA
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