MEDICARE: DR. YVETTE MARIE LOPEZ-GRANBERRY M.D.

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	207R00000X	Internal Medicine Physician	ME59258	FL

General Provider Information

NPI Number	:	1750384772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YVETTE MARIE LOPEZ-GRANBERRY M.D.

Provider Business Mailing Address
First Line	:	456 PRESTWICK CT
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32940-1876
Country	:	US
Telephone Number	:	321-254-2016
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 N WICKHAM RD
Second Line	:	STE 101
City	:	MELBOURNE
State	:	FL
Zip	:	32940-2023
Country	:	US
Telephone Number	:	321-253-2169
Fax Number	:	321-253-1720

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/22/2013

Similar Medicare Providers

1417950429 — DR. FRANK JOSEPH LISTELLO JR. M.D.
Practice Location Address:

6300 N WICKHAM RD , STE 101
MELBOURNE, FL
32940-2023

Practice Phone: 321-253-2169
Practice Fax: 321-253-1720

1376529883 — DR. KIMBERLY MCGRATH MD
Practice Location Address:

6300 N WICKHAM RD STE 132A
MELBOURNE, FL
32940-2023

Practice Phone: 321-253-4032
Practice Fax: 321-253-4125

1134193816 — ELLEN M ALTENBURG MD
Practice Location Address:

6300 N WICKHAM RD STE 132B
MELBOURNE, FL
32940-2023

Practice Phone: 321-425-6900
Practice Fax: 321-802-5599

1942314265 — KATHLEEN MARY BOVEE NP
Practice Location Address:

6300 N WICKHAM RD STE 132A
MELBOURNE, FL
32940-2023

Practice Phone: 321-253-4032
Practice Fax: 321-253-4125

1457542854 — EYE DOCTORS OPTICAL OUTLETS PA
Practice Location Address:

6300 N WICKHAM RD STE 131
MELBOURNE, FL
32940-2023

Practice Phone: 321-751-7270
Practice Fax:

1043583289 — KELLY M LIENEKE LMT
Practice Location Address:

6300 N WICKHAM RD STE 116
MELBOURNE, FL
32940-2023

Practice Phone: 321-757-6899
Practice Fax: 321-757-6859

Directions to “ DR. YVETTE MARIE LOPEZ-GRANBERRY M.D.” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.