MEDICARE: MRS. KAREN LIZETTE LOPEZ-FELICIANO LMHC 7049

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	LMHC 7049	FL

General Provider Information

NPI Number	:	1932206471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN LIZETTE LOPEZ-FELICIANO LMHC 7049

Provider Business Mailing Address
First Line	:	17909 CADENCE ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32820-2729
Country	:	US
Telephone Number	:	321-689-5697
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 W BROWARD BLVD STE 100
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-1018
Country	:	US
Telephone Number	:	321-689-5697
Fax Number	:

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

Provider Enumeration Date	:	09/19/2006
Last Update Date	:	01/18/2012

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