Provider Demographics
NPI:1811879976
Name:LOPEZ, CHELSI
Entity type:Individual
Prefix:
First Name:CHELSI
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 TRYMORE DR SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-2373
Mailing Address - Country:US
Mailing Address - Phone:319-471-7921
Mailing Address - Fax:
Practice Address - Street 1:5200 28TH ST N LOT 358
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33714-2581
Practice Address - Country:US
Practice Address - Phone:319-212-0971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health