Individual
MS. IRYNA YUSUPOVA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., ITDS
Contact information
Practice address
3261 US HWY 441 UNIT B3, FRUITLAND PARK, FL 34731
(352) 323-0612
Mailing address
1526 PROVIDENCE CIR, ORLANDO, FL 32818-5708
(352) 394-0212
(352) 241-6361
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
811804300
—
FL
Enumeration date
01/18/2007
Last updated
02/17/2025
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