Organization
OLIVE VERDE COMPANY LLC
Active
Other names
Olivo Verde Company, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANNA K LOPEZ RDN, LD/N (OWNER)
(813) 546-1143
Entity
Organization
Contact information
Practice address
859 W LUMSDEN RD, BRANDON, FL 33511-6280
(813) 546-1143
(813) 684-0804
Mailing address
2231 VALTERRA VISTA WAY, VALRICO, FL 33594-4412
(813) 546-1143
(813) 684-0804
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
ND4125
FL
Other
Enumeration date
06/20/2018
Last updated
09/09/2019
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