Provider Demographics
NPI:1457975799
Name:LOPEZ VALERO, PAULA ANDREA (MD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ANDREA
Last Name:LOPEZ VALERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:A
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1855 VETERANS PARK DR STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0446
Mailing Address - Country:US
Mailing Address - Phone:239-260-1033
Mailing Address - Fax:239-260-1491
Practice Address - Street 1:1855 VETERANS PARK DR STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0446
Practice Address - Country:US
Practice Address - Phone:239-260-1033
Practice Address - Fax:239-260-1491
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162340207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL120539200Medicaid