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General NPI Number Information
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NPI Number | 1497304729
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Entity Type | Individual
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Provider Name | KIMBERLY ANN LOPEZ CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 4300 ALTON RD DEPT OF
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2948
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Country | US
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Telephone | 305-674-2387
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Fax |
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Provider Business Mailing Address
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Address Line | 22522 SW 126TH AVE
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City | MIAMI
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State | FL
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Zip | 33170-6320
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Country | US
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Telephone | 786-759-3857
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9308573
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN11005626
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024180511
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License Number State | VA
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