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Individual
NICOLE LOPEZ
Active
Individual
NICOLE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,LAT,ATC
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
LAT-4037
NC
207X00000X
Orthopaedic Surgery Physician
AL-6213
FL
Other
Enumeration date
12/09/2019
Last updated
08/31/2022
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