Individual
MS. IDALMIS LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11351 SW 1ST ST, PLANTATION, FL 33325-2932
(786) 367-7132
Mailing address
11351 SW 1ST ST, PLANTATION, FL 33325-2932
(786) 367-7132
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2024043904
FL
Other
Enumeration date
10/14/2021
Last updated
05/19/2025
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