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General NPI Number Information
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NPI Number | 1104554534
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Entity Type | Individual
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Provider Name | TONI LOPEZ LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 4310 METRO PKWY STE 205
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City | FORT MYERS
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State | FL
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Zip | 33916-9416
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Country | US
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Telephone | 239-690-6906
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Fax |
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Provider Business Mailing Address
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Address Line | 2847 ORCHID LN
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City | LAKELAND
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State | FL
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Zip | 33805-7540
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Country | US
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Telephone | 631-530-1601
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH25393
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License Number State | FL
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