Individual
ODALIS LOPEZ GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16801 SW 109TH CT, 16801 SW 109 CT, MIAMI, FL 33157-4054
(786) 227-7649
Mailing address
16801 SW 109TH CT, MIAMI, FL 33157-4054
(786) 227-7649
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11043298
FL
Other
Enumeration date
11/01/2025
Last updated
11/01/2025
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