MEDICARE: DR. AIDA J LOPEZ DNP, APRN, FNP-C

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	363LF0000X	Family Nurse Practitioner	APRN3350702	FL
2	363L00000X	Nurse Practitioner	APRN3350702	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497717854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AIDA J LOPEZ DNP, APRN, FNP-C

Provider Business Mailing Address
First Line	:	2160 COLONIAL BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1410
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	2964 N STATE ROAD 7 STE 330
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-5715
Country	:	US
Telephone Number	:	954-984-9998
Fax Number	:	954-984-9988

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

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	02/12/2019

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Directions to “ DR. AIDA J LOPEZ DNP, APRN, FNP-C” Practice Location

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