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Organization
MEDILIFE MENTAL HEALTH LLC
Active
Organization
MEDILIFE MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YUL LOPEZ PMHNP-BC (OWNER)
(813) 599-2784
Entity
Organization
Contact information
Practice address
4705 SW 148TH AVE STE 102, DAVIE, FL 33330-2123
(954) 349-6378
(954) 983-2889
Mailing address
4705 SW 148TH AVE STE 102, DAVIE, FL 33330-2123
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/02/2026
Last updated
09/02/2026
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