Provider Demographics
NPI:1427719541
Name:LOPEZ FERNANDEZ, PATRICIA (NP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:LOPEZ FERNANDEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5576
Mailing Address - Country:US
Mailing Address - Phone:786-397-5461
Mailing Address - Fax:
Practice Address - Street 1:6550 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5576
Practice Address - Country:US
Practice Address - Phone:786-397-5461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF11210457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily