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General NPI Number Information
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NPI Number | 1790653889
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Entity Type | Individual
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Provider Name | CORAL LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 10/29/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 3200 SW 34TH AVE STE 701
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City | OCALA
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State | FL
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Zip | 34474-8443
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Country | US
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Telephone | 877-779-2429
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Fax | 882-484-4348
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Provider Business Mailing Address
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Address Line | 2316 POWELL CIR
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City | SARASOTA
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State | FL
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Zip | 34234-6341
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Country | US
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Telephone | 941-580-8398
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11042816
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License Number State | FL
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