Individual
ADDARIS LOPEZ HERRERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 NW 31ST AVE, FORT LAUDERDALE, FL 33311-7644
(786) 970-8297
Mailing address
510 NW 31ST AVE, FORT LAUDERDALE, FL 33311-7644
(786) 970-8297
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-146993
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113274000
—
FL
Enumeration date
09/13/2022
Last updated
09/13/2022
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