Provider Demographics
NPI:1811607518
Name:LOPEZ MARTIN, LIUVITZA
Entity type:Individual
Prefix:
First Name:LIUVITZA
Middle Name:
Last Name:LOPEZ MARTIN
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 1:12301 ADAIR CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2689
Mailing Address - Country:US
Mailing Address - Phone:813-318-2586
Mailing Address - Fax:
Practice Address - Street 1:12301 ADAIR CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-2689
Practice Address - Country:US
Practice Address - Phone:813-318-2586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide