Healthcare Provider Details

I. General information

NPI: 1255954228
Provider Name (Legal Business Name): CRISTINA IRENE LOPEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRISTINA IRENE DROZ

II. Dates (important events)

Enumeration Date: 05/25/2020
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 S EUSTIS ST
EUSTIS FL
32726-5558
US

IV. Provider business mailing address

1101 S EUSTIS ST
EUSTIS FL
32726-5558
US

V. Phone/Fax

Practice location:
  • Phone: 352-589-9661
  • Fax: 352-589-5983
Mailing address:
  • Phone: 352-589-9661
  • Fax: 352-589-5983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11005698
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberAPRN11005698
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11005698
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPRN11005698
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: