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Individual

DR. LIDYA MARGARITA LATABAN-LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
20 CYPRESS POINT PKWY STE A, PALM COAST, FL 32164-7528
(386) 586-7005
(844) 867-3940
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(305) 500-2000

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
15204
PR
208D00000X
General Practice Physician
Primary
ACN911
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22385
TRIPLE S DE PUERTO RICO
PR
01
9700031
HUMANA
PR
01
ACN911
FLORIDA LICENSE
FL
01
B159
FIRST MEDICAL
PR
Enumeration date
05/05/2006
Last updated
02/17/2026
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