Individual ProviderMario Enrique LopezBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address3664 SW 150th Ct, Miami, FL 33185-3968(786) 368-3414PECOS EnrollmentBased on the most recent information from CMS, provider Mario Enrique Lopez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1386129351Provider TypeIndividualFull NameLopez, Mario EnriqueGenderMaleSole ProprietorYesEnumeration Date9/26/2018Last Updated9/26/2018Contact InformationPractice LocationPractice Address3664 SW 150th Ct, Miami, FL 33185-3968Phone(786) 368-3414FaxUnlisted FaxMailing LocationMailing Address3664 SW 150th Ct, Miami, FL 33185-3968PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerFlorida