Healthcare Provider Details

I. General information

NPI: 1548623804
Provider Name (Legal Business Name): ANA LOPEZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2016
Last Update Date: 04/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 NW 9TH AVE
MIAMI FL
33136-1101
US

IV. Provider business mailing address

1801 NW 9TH AVE
MIAMI FL
33136-1101
US

V. Phone/Fax

Practice location:
  • Phone: 305-355-5112
  • Fax: 305-355-5791
Mailing address:
  • Phone: 305-355-5000
  • Fax: 305-355-5791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9326135
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: