Healthcare Provider Details

I. General information

NPI: 1518697960
Provider Name (Legal Business Name): NATALIA LOPEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 06/16/2022
Certification Date: 06/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4809 N ARMENIA AVE
TAMPA FL
33603-1447
US

IV. Provider business mailing address

5530 TURTLE CROSSING LOOP
TAMPA FL
33625-2538
US

V. Phone/Fax

Practice location:
  • Phone: 813-658-5037
  • Fax:
Mailing address:
  • Phone: 954-682-5467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License Number9332101
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: