Healthcare Provider Details

I. General information

NPI: 1922895721
Provider Name (Legal Business Name): FLOR D. LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 CLARK ST
RANDOLPH MA
02368-3612
US

IV. Provider business mailing address

32 CLARK ST
RANDOLPH MA
02368-3612
US

V. Phone/Fax

Practice location:
  • Phone: 781-534-2835
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2262507
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: