Individual
MRS. ELIZABETH LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
841 JIMMY ANN DR, DAYTONA BEACH, FL 32117-4583
(386) 425-3900
(386) 274-1561
Mailing address
1293 SUNNINGDALE LN, ORMOND BEACH, FL 32174-1406
(386) 837-3250
(386) 274-1561
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
IMH11795
FL
Other
Enumeration date
11/26/2013
Last updated
11/26/2013
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