MEDICARE: YANERIS LOPEZ PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11042296	FL

General Provider Information

NPI Number	:	1992668750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANERIS LOPEZ PMHNP

Provider Business Mailing Address
First Line	:	7261 SHERIDAN ST STE 340
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2726
Country	:	US
Telephone Number	:	954-561-6222
Fax Number	:	954-990-7650

Provider Business Practice Location Address
First Line	:	5901 SW 74TH ST STE 408
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5164
Country	:	US
Telephone Number	:	305-735-3555
Fax Number	:	954-990-7650

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/15/2025

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