Individual
BETTY LOPEZ-MANTILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12555 ORANGE DR, SUITE 222, DAVIE, FL 33330-4304
(954) 862-1707
Mailing address
901 NE 14TH AVE, APT 701, HALLANDALE BEACH, FL 33009-2754
(954) 549-5968
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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