MEDICARE: MRS. ALICIA LOPEZ ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	ARNP9212694	FL

General Provider Information

NPI Number	:	1548667207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICIA LOPEZ ARNP

Provider Business Mailing Address
First Line	:	2858 MAPLE BROOK LOOP
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-5050
Country	:	US
Telephone Number	:	813-317-6122
Fax Number	:

Provider Business Practice Location Address
First Line	:	2858 MAPLE BROOK LOOP
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-5050
Country	:	US
Telephone Number	:	813-317-6122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2014
Last Update Date	:	11/24/2014

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