Healthcare Provider Details

I. General information

NPI: 1609722180
Provider Name (Legal Business Name): BEATRIZ VALERIA LOPEZ GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9801 BELVEDERE RD
ROYAL PALM BEACH FL
33411-3640
US

IV. Provider business mailing address

9801 BELVEDERE RD
ROYAL PALM BEACH FL
33411-3640
US

V. Phone/Fax

Practice location:
  • Phone: 561-273-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number9121734
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: