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Individual

TIFFANY MARIE LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1850 PREVATT ST, EUSTIS, FL 32726-6123
(352) 253-2511
Mailing address
1850 PREVATT ST, EUSTIS, FL 32726-6123

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
11045638
FL

Other

Enumeration date
05/12/2026
Last updated
05/12/2026
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