Individual
SANDRA B LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9850 S FEDERAL HIGHWAY, PORT ST LUCIE, FL 34972
(772) 335-1500
(772) 335-1116
Mailing address
5807 NW ALLYSE DR, PORT ST LUCIE, FL 34986-4650
(772) 905-2583
(772) 335-1116
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9103461
FL
Other
Enumeration date
10/02/2006
Last updated
01/30/2009
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