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General NPI Number Information
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NPI Number | 1972147775
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Entity Type | Individual
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Provider Name | YUDELKA LOPEZ PAMPIN APRN
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Gender | Female
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Dates
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Enumeration Date | 11/05/2019
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 1140 S SEMORAN BLVD STE E
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City | ORLANDO
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State | FL
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Zip | 32807-1459
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Country | US
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Telephone | 407-384-9165
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Fax | 407-384-9174
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Provider Business Mailing Address
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Address Line | 5575 S SEMORAN BLVD STE 26
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City | ORLANDO
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State | FL
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Zip | 32822-1781
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Country | US
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Telephone | 407-401-8637
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Fax | 407-401-8610
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11004224
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License Number State | FL
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