Provider Demographics
NPI:1306612809
Name:LOPEZ, NORA (BA, CBHCM)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:BA, CBHCM
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BA, CBHCM
Mailing Address - Street 1:140 FLORIDA PKWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-6308
Mailing Address - Country:US
Mailing Address - Phone:407-729-4701
Mailing Address - Fax:
Practice Address - Street 1:140 FLORIDA PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34743-6308
Practice Address - Country:US
Practice Address - Phone:407-729-4701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator