Individual
YASHIRA MARIE RIVERA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 CYPRESS PKWY STE B, KISSIMMEE, FL 34759-3424
(407) 913-1010
(407) 992-8697
Mailing address
1252 S JOHN YOUNG PKWY, KISSIMMEE, FL 34741-6319
(407) 913-1010
(407) 992-8697
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI3986
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SI3986
FLORIDA DOH STATE LICENSE
FL
Enumeration date
11/20/2019
Last updated
11/20/2019
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