Individual
ERIXIS LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3228 SAN JOSE MISSION DR, DOVER, FL 33527-4746
(727) 748-5765
Mailing address
1004 ROCHELLE LN, VALRICO, FL 33594-6634
(813) 863-8980
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9108765
FL
Other
Enumeration date
04/03/2016
Last updated
04/03/2016
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