MEDICARE: TIFFANY MARIE LOPEZ

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	363LG0600X	Gerontology Nurse Practitioner	11045638	FL

General Provider Information

NPI Number	:	1790613560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY MARIE LOPEZ

Provider Business Mailing Address
First Line	:	1850 PREVATT ST
Second Line	:
City	:	EUSTIS
State	:	FL
Zip	:	32726-6123
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 PREVATT ST
Second Line	:
City	:	EUSTIS
State	:	FL
Zip	:	32726-6123
Country	:	US
Telephone Number	:	352-253-2511
Fax Number	:

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

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

Similar Medicare Providers

1306844964 — STEPHEN E YOUNG DO
Practice Location Address:

1850 PREVATT ST
EUSTIS, FL
32726-6123

Practice Phone: 352-253-2511
Practice Fax: 352-253-2522

1598782401 — TRINITY FAMILY MEDICAL CENTER, PA
Practice Location Address:

1850 PREVATT ST
EUSTIS, FL
32726-6123

Practice Phone: 352-253-2511
Practice Fax: 352-253-2522

1528349297 — MONIQUE PRINCE FNP-C
Practice Location Address:

1850 PREVATT ST
EUSTIS, FL
32726-6123

Practice Phone: 352-253-2511
Practice Fax: 352-253-2511

1144947243 — GAYE-ANN M MATTHEWS APRN
Practice Location Address:

1850 PREVATT ST
EUSTIS, FL
32726-6123

Practice Phone: 352-253-2511
Practice Fax: 352-253-2525

1033040258 — MITHRA WILLIAMS
Practice Location Address:

1217 HUFFSTETLER DR
EUSTIS, FL
32726-8225

Practice Phone: 352-483-1652
Practice Fax: 352-360-6656

1780525238 — BEAUTIFUL MIND COUNSELING LLC
Practice Location Address:

1755 LAKE TERRACE DR
EUSTIS, FL
32726-5739

Practice Phone: 352-638-3515
Practice Fax:

Directions to “ TIFFANY MARIE LOPEZ ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.