Provider Demographics
NPI:1245929504
Name:LOPEZ, DENNIA
Entity type:Individual
Prefix:MISS
First Name:DENNIA
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 1:7690 TARA CIR APT 203
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-7425
Mailing Address - Country:US
Mailing Address - Phone:239-776-4389
Mailing Address - Fax:239-776-7326
Practice Address - Street 1:7690 TARA CIR APT 203
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-7425
Practice Address - Country:US
Practice Address - Phone:239-776-4389
Practice Address - Fax:239-776-7326
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL62514653374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide