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Organization

RAPHA FAMILY CENTRE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LUIS W LOPEZ PHD (OWNER)
(787) 673-1486
Entity
Organization

Contact information

Practice address
2008 N GOLDENROD RD BLDG 300, ORLANDO, FL 32807-8544
(321) 440-7193
Mailing address
2008 N GOLDENROD RD BLDG 300, ORLANDO, FL 32807-8544
(321) 440-7193

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103G00000X
Clinical Neuropsychologist
Primary
103TA0700X
Adult Development & Aging Psychologist
103TC2200X
Clinical Child & Adolescent Psychologist
103TF0000X
Family Psychologist
103TR0400X
Rehabilitation Psychologist
261Q00000X
Clinic/Center
261QC1500X
Community Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
09/01/2022
Last updated
02/14/2023
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