Healthcare Provider Details

I. General information

NPI: 1487062451
Provider Name (Legal Business Name): EVELYN LOPEZ-BRIGNONI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 BILTMORE WAY STE 204
CORAL GABLES FL
33134-5736
US

IV. Provider business mailing address

475 BILTMORE WAY STE 204
CORAL GABLES FL
33134-5736
US

V. Phone/Fax

Practice location:
  • Phone: 305-670-1411
  • Fax: 305-670-2811
Mailing address:
  • Phone: 305-670-1411
  • Fax: 305-670-2811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME0054458
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME0054458
License Number StateFL

VIII. Authorized Official

Name: DR. EVELYN LOPEZ BRIGNONI
Title or Position: OWNER
Credential: MD
Phone: 305-670-1411