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General NPI Number Information
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NPI Number | 1083478713
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Entity Type | Individual
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Provider Name | CHRISTIAN LOPEZ FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 3066 SW MARTIN DOWNS BLVD STE C
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City | PALM CITY
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State | FL
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Zip | 34990-2683
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Country | US
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Telephone | 772-781-2791
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Fax |
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Provider Business Mailing Address
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Address Line | 17221 NW 94TH CT APT 107
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City | MIAMI LAKES
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State | FL
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Zip | 33018-4360
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Country | US
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Telephone | 786-315-3236
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11031224
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License Number State | FL
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