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General NPI Number Information
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NPI Number | 1770233033
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Entity Type | Individual
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Provider Name | ILIANA MICHELLE LOPEZ OTR
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Gender | Female
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1140 W 50TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-3440
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Country | US
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Telephone | 305-231-3371
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Fax |
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Provider Business Mailing Address
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Address Line | 6941 NW 173RD DR APT 206
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City | HIALEAH
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State | FL
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Zip | 33015-5587
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Country | US
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Telephone | 786-527-0651
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT26711
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License Number State | FL
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