Individual
ELENA LOPEZ CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18500 VETERANS BLVD UNIT 4, PORT CHARLOTTE, FL 33954-1035
(941) 743-7449
Mailing address
2623 SW 4TH LN, CAPE CORAL, FL 33991-1118
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC5646
FL
Other
Enumeration date
05/26/2019
Last updated
02/21/2024
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