Provider Demographics
NPI:1679984561
Name:LOPEZ, OFELIA ALESSANDRA (MD)
Entity type:Individual
Prefix:
First Name:OFELIA
Middle Name:ALESSANDRA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 15TH AVE E
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-2639
Mailing Address - Country:US
Mailing Address - Phone:914-815-7905
Mailing Address - Fax:
Practice Address - Street 1:6804 CECELIA DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-4935
Practice Address - Country:US
Practice Address - Phone:727-232-0644
Practice Address - Fax:888-546-0488
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME133609208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine