MEDICARE: MS. GELIANI R. LOPEZ LMHC

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	101YM0800X	Mental Health Counselor	MH 6878	FL

General Provider Information

NPI Number	:	1801989397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GELIANI R. LOPEZ LMHC

Provider Business Mailing Address
First Line	:	330 SW 51 COURT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33134
Country	:	US
Telephone Number	:	786-262-0346
Fax Number	:

Provider Business Practice Location Address
First Line	:	5753 MIAMI LAKES DR. EAST
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33015
Country	:	US
Telephone Number	:	305-403-0006
Fax Number	:

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/08/2007

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