Individual
WANDA ROSARIO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
24698 NW 23RD LN, NEWBERRY, FL 32669-0405
(352) 219-7840
Mailing address
24698 NW 23RD LN, NEWBERRY, FL 32669-0405
(352) 219-7840
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN9513254
FL
Other
Enumeration date
05/01/2026
Last updated
05/01/2026
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