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NPI Code Detail

MEDICARE: MELISSA MAE LOPEZ

MEDICARE: MELISSA MAE LOPEZ
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
1103K00000XBehavior Analyst1-24-71477FL

Other Identifiers

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

General Provider Information

NPI Number : 1568001212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA MAE LOPEZ
Provider Business Mailing Address
First Line : 10368 CARROLLWOOD LN APT 203
Second Line :
City : TAMPA
State : FL
Zip : 33618-4730
Country : US
Telephone Number : 561-667-5768
Fax Number :
Provider Business Practice Location Address
First Line : 11602 N 51ST ST
Second Line :
City : TAMPA
State : FL
Zip : 33617-2132
Country : US
Telephone Number : 813-914-8869
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2019
Last Update Date : 02/28/2024

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Directions to “ MELISSA MAE LOPEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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