Individual
VIANKA RAQUEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 WALTHAM CT, DAVENPORT, FL 33897-4830
(407) 766-5860
Mailing address
124 WALTHAM CT, DAVENPORT, FL 33897-4830
(407) 766-5860
Taxonomy
Speciality
Code
Description
License number
State
246Q00000X
Pathology Specialist/Technologist
Primary
SI4906
FL
Other
Enumeration date
07/02/2025
Last updated
07/08/2025
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