Individual
NICOLE MARIE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(228) 376-2273
Mailing address
3165 SW 133RD PL, MIAMI, FL 33175-6653
(786) 269-8043
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
35.151039
OH
Other
Enumeration date
04/15/2022
Last updated
07/07/2025
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