Individual
LUCIA LOPEZ FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
813 S PARSONS AVE, BRANDON, FL 33511-6063
(813) 662-4841
Mailing address
1710 ERIN BROOKE DR, VALRICO, FL 33594-4055
(915) 203-4971
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
022529
PR
208D00000X
General Practice Physician
Primary
ACN1376
FL
390200000X
Student in an Organized Health Care Education/Training Program
15636I
PR
Other
Enumeration date
04/21/2021
Last updated
01/23/2022
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