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Individual
IVONNE ILEANA JACOMINO LOPEZ
Active
Individual
IVONNE ILEANA JACOMINO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9342058
FL
363LF0000X
Family Nurse Practitioner
Primary
11009290
FL
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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