Healthcare Provider Details

I. General information

NPI: 1457975799
Provider Name (Legal Business Name): PAULA ANDREA LOPEZ VALERO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULA A LOPEZ MD

II. Dates (important events)

Enumeration Date: 06/02/2020
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 VETERANS PARK DR STE 201
NAPLES FL
34109-0446
US

IV. Provider business mailing address

1855 VETERANS PARK DR STE 201
NAPLES FL
34109-0446
US

V. Phone/Fax

Practice location:
  • Phone: 239-260-1033
  • Fax: 239-260-1491
Mailing address:
  • Phone: 239-260-1033
  • Fax: 239-260-1491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME162340
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: