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General NPI Number Information
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NPI Number | 1770991341
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Entity Type | Individual
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Provider Name | ZULMA LOPEZ RIVERA MD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 1114 SR 20 STE 100
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City | INTERLACHEN
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State | FL
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Zip | 32148
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Country | US
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Telephone | 386-684-0195
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Fax | 386-684-0229
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Provider Business Mailing Address
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Address Line | 2460 OLD MOULTRIE RD STE 1
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-4198
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Country | US
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Telephone | 904-293-0299
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN1778
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 18795
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License Number State | PR
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