Individual
MARIENELLI LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1831 BROCKRIDGE RD, KINDRED, FL 34744-6069
(407) 399-0524
Mailing address
1831 BROCKRIDGE RD, KINDRED, FL 34744-6069
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9465232
FL
Other
Enumeration date
09/28/2019
Last updated
09/28/2019
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