Individual
MRS. KRYSTAL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3661 S BABCOCK ST FL 2, MELBOURNE, FL 32901-8205
(321) 434-7611
(321) 727-3738
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-7611
(321) 951-7408
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN9314840
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101310900
—
FL
01
—
KN043
MEDICARE
FL
Enumeration date
02/27/2017
Last updated
07/25/2024
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