Provider Demographics
NPI:1497209704
Name:LOPEZ ALONSO, AYLIN (ARNP)
Entity Type:Individual
Prefix:
First Name:AYLIN
Middle Name:
Last Name:LOPEZ ALONSO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18459 PINES BLVD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1400
Mailing Address - Country:US
Mailing Address - Phone:954-675-6566
Mailing Address - Fax:
Practice Address - Street 1:3157 N UNIVERSITY DR
Practice Address - Street 2:SUITE 107
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2258
Practice Address - Country:US
Practice Address - Phone:954-990-0595
Practice Address - Fax:954-827-2900
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9328231363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9328231OtherMEDICAL LICENSE