MEDICARE: MR. ALDO R LOPEZ MSC/CCP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP1600X	Pastoral Counselor		FL

General Provider Information

NPI Number	:	1295680577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALDO R LOPEZ MSC/CCP

Provider Business Mailing Address
First Line	:	4653 W IRLO BRONSON MEMORIAL HWY STE 102
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-5349
Country	:	US
Telephone Number	:	407-799-9990
Fax Number	:

Provider Business Practice Location Address
First Line	:	4653 W IRLO BRONSON MEMORIAL HWY STE 102
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-5349
Country	:	US
Telephone Number	:	407-799-9990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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