Provider Demographics
NPI:1548539000
Name:LOPEZ LINNIKOV, DIMITRI P (MD)
Entity type:Individual
Prefix:
First Name:DIMITRI
Middle Name:P
Last Name:LOPEZ LINNIKOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3541 SW 142ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4705
Mailing Address - Country:US
Mailing Address - Phone:239-738-1455
Mailing Address - Fax:
Practice Address - Street 1:3541 SW 142ND AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4705
Practice Address - Country:US
Practice Address - Phone:239-738-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115729207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology