Individual
MERCEDES LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4175 W 20TH AVE, HIALEAH, FL 33012-5874
(305) 825-0300
Mailing address
4175 W 20TH AVE, HIALEAH, FL 33012-5874
(305) 825-0300
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
763939200
—
FL
Enumeration date
08/23/2010
Last updated
11/17/2025
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