Individual
DR. IVELISSE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2880 S OSCEOLA AVE, ORLANDO, FL 32806-5431
(407) 843-0443
(407) 843-0442
Mailing address
2880 S OSCEOLA AVE, ORLANDO, FL 32806-5431
(407) 843-0443
(407) 843-0442
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME82595
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262579200
—
FL
Enumeration date
02/23/2006
Last updated
03/07/2023
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