MEDICARE: MS. LAURA LOPEZ FERNANDEZ BCBA

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	103K00000X	Behavior Analyst	BCBA-1-25-86264	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679127120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA LOPEZ FERNANDEZ BCBA

Provider Business Mailing Address
First Line	:	940 NW 8TH STREET RD APT 9
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-3148
Country	:	US
Telephone Number	:	305-492-5617
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 NW 8TH STREET RD APT 9
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-3148
Country	:	US
Telephone Number	:	305-492-5617
Fax Number	:

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

Provider Enumeration Date	:	08/01/2019
Last Update Date	:	01/05/2026

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