Provider Demographics
NPI:1992334502
Name:LOPEZ, LANNA (FNP)
Entity type:Individual
Prefix:MS
First Name:LANNA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SUMMERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-7971
Mailing Address - Country:US
Mailing Address - Phone:646-314-3503
Mailing Address - Fax:
Practice Address - Street 1:1230 OAKLEY SEAVER DR STE 101
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1961
Practice Address - Country:US
Practice Address - Phone:407-274-9322
Practice Address - Fax:407-274-9907
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL000000163WR1000X
FL11006875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR1000XNursing Service ProvidersRegistered NurseReproductive Endocrinology/Infertility