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General NPI Number Information
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NPI Number | 1043170913
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Entity Type | Individual
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Provider Name | STEPHANIE MARIE LOPEZ HHA
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Gender | Female
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 1054 STATE ROAD 60 E
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City | LAKE WALES
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State | FL
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Zip | 33853-4218
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Country | US
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Telephone | 863-664-1064
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Fax |
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Provider Business Mailing Address
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Address Line | 1054 STATE ROAD 60 E
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City | LAKE WALES
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State | FL
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Zip | 33853-4218
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Country | US
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Telephone | 863-664-1064
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 264956
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 264956
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 264956
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License Number State | FL
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