Healthcare Provider Details

I. General information

NPI: 1285569129
Provider Name (Legal Business Name): SAIDY LOPEZ PEDROSO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 LEE BLVD
LEHIGH ACRES FL
33971-1723
US

IV. Provider business mailing address

4105 LEE BLVD
LEHIGH ACRES FL
33971-1723
US

V. Phone/Fax

Practice location:
  • Phone: 239-737-0813
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-544553
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: