Individual
MRS. MELBA DOLORES LOPEZ DE VICTORIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1304 OAK ST, MELBOURNE, FL 32904-3111
(321) 723-4723
(321) 727-1448
Mailing address
1707 SIENNA DR, MELBOURNE, FL 32934-9030
(321) 286-6085
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
9223165
FL
Other
Enumeration date
06/22/2012
Last updated
07/02/2012
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