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General NPI Number Information
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NPI Number | 1326554825
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Entity Type | Individual
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Provider Name | MELISSA ANNE LOPEZ ARNP
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Gender | Female
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 12/19/2017
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Provider Practice Location Address
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Address Line | 4152 W BLUE HERON BLVD STE 123
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-4859
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Country | US
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Telephone | 561-844-7699
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Fax | 561-842-8261
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Provider Business Mailing Address
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Address Line | PO BOX 221022
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City | WEST PALM BEACH
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State | FL
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Zip | 33422-1022
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Country | US
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Telephone | 561-352-7953
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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 | L17000232878
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License Number State | FL
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