# MEDILIFE MENTAL HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689583197
- **Authorized official:** YUL LOPEZ PMHNP-BC (OWNER)
- **Authorized official phone:** (813) 599-2784

## Contact information

- **Practice address:** 4705 SW 148TH AVE STE 102, DAVIE, FL 33330-2123
- **Practice address phone:** (954) 349-6378
- **Practice address fax:** (954) 983-2889
- **Mailing address:** 4705 SW 148TH AVE STE 102, DAVIE, FL 33330-2123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/02/2026
- **Last updated:** 09/02/2026