Provider Demographics
NPI:1558082008
Name:LOPEZ LOPEZ, ANYELEY (DMD)
Entity type:Individual
Prefix:
First Name:ANYELEY
Middle Name:
Last Name:LOPEZ LOPEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 W PLANTATION CIR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1420
Mailing Address - Country:US
Mailing Address - Phone:239-272-2391
Mailing Address - Fax:
Practice Address - Street 1:47 BARKLEY CIR STE A
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-7734
Practice Address - Country:US
Practice Address - Phone:239-542-3925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL275061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice