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Individual

JANELLE I LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4934 SEMINOLE AVE, WINTER PARK, FL 32792-7123
(407) 760-3416
Mailing address
4934 SEMINOLE AVE, WINTER PARK, FL 32792-7123
(407) 760-3416

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
13482
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
13482
FL
Enumeration date
06/23/2020
Last updated
07/23/2020
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