Individual
SUSANA LOPES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
11652 BENTRY ST, ORLANDO, FL 32824-4408
(407) 697-4590
Mailing address
11652 BENTRY ST, ORLANDO, FL 32824-4408
(407) 697-4590
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3392
FL
Other
Enumeration date
03/11/2013
Last updated
03/11/2013
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