Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APRN9308194 | FL |
NPI | 1114415650 |
---|---|
Provider Name | Aylin Lazara Lopez |
First Address | Miami, FL 33143-4262 |
Second Address | Coral Gables, FL 33133-4841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2018 |
Last Update Date | 12/03/2020 |