Provider Demographics
NPI:1801238928
Name:LOPEZ, ANA LIZETT (AGPCNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:LIZETT
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3434 HANCOCK BRIDGE PKWY STE 301
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-7094
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:239-599-2612
Practice Address - Street 1:4881 PALM BEACH BLVD
Practice Address - Street 2:STE 100
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-3217
Practice Address - Country:US
Practice Address - Phone:239-693-9191
Practice Address - Fax:239-693-7369
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9180599363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology