Individual
MRS. MAYDA V LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
214 E OAK ST, KISSIMMEE, FL 34744-4535
(407) 575-4636
Mailing address
2309 SANTA ANA ST, KISSIMMEE, FL 34743-3338
(407) 873-0983
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
CNA183851
FL
Other
Enumeration date
05/26/2010
Last updated
05/27/2010
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