Provider Demographics
NPI:1811034366
Name:NAVAS LOPEZ, SANDRA ELIZABETH (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ELIZABETH
Last Name:NAVAS LOPEZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:ELIZABETH
Other - Last Name:TROVATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:5847 HENSEL RD
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-5810
Mailing Address - Country:US
Mailing Address - Phone:386-316-8934
Mailing Address - Fax:
Practice Address - Street 1:5847 HENSEL RD
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-5810
Practice Address - Country:US
Practice Address - Phone:386-316-8934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA4641235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist