Provider Demographics
NPI:1699292078
Name:LOPEZ, LIZMARIE MORALES (PHARMD)
Entity type:Individual
Prefix:
First Name:LIZMARIE
Middle Name:MORALES
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6627 W BOYNTON BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3526
Mailing Address - Country:US
Mailing Address - Phone:561-731-2070
Mailing Address - Fax:561-731-2618
Practice Address - Street 1:6627 W BOYNTON BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3526
Practice Address - Country:US
Practice Address - Phone:561-731-2070
Practice Address - Fax:561-731-2618
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL56968183500000X
FLPS56968183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty