Individual
JUAN J LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 E MAUD ST, TAVARES, FL 32778-3249
(352) 253-9348
(352) 253-9351
Mailing address
101 E MAUD ST, TAVARES, FL 32778-3249
(352) 253-9348
(352) 253-9351
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
SS648
FL
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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