Individual
DIORGI LOPEZ SURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
2624 ATLANTIC BLVD, JACKSONVILLE, FL 32207-3609
(904) 513-3240
Mailing address
6821 SOUTHPOINT DR N STE 107, JACKSONVILLE, FL 32216-8026
(866) 372-0308
(877) 460-4651
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11011948
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26778220
—
NM
Enumeration date
05/30/2018
Last updated
10/05/2021
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