Individual
JASMINE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
17325 OLD TOBACCO RD, LUTZ, FL 33558-4953
(302) 824-2190
Mailing address
17325 OLD TOBACCO RD, LUTZ, FL 33558-4953
(302) 824-2190
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
22700
FL
225XP0200X
Pediatric Occupational Therapist
22700
FL
Other
Enumeration date
02/03/2022
Last updated
02/03/2022
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