Individual
DR. GRISELL LOPEZ-FRAGOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4560 LANTANA RD STE 110&115, LAKE WORTH, FL 33463-6998
(888) 726-5116
Mailing address
4560 LANTANA RD STE 110&115, LAKE WORTH, FL 33463-6998
(888) 726-5116
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
19938
PR
208D00000X
General Practice Physician
Primary
ACN1400
FL
Other
Enumeration date
07/27/2015
Last updated
02/14/2025
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