Provider Demographics
NPI:1144885559
Name:LOPEZ, CYNTHIA IVY (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:IVY
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:448 SE OSCEOLA ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2577
Mailing Address - Country:US
Mailing Address - Phone:772-276-7242
Mailing Address - Fax:772-237-3109
Practice Address - Street 1:448 SE OSCEOLA ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2577
Practice Address - Country:US
Practice Address - Phone:772-276-7242
Practice Address - Fax:772-237-3109
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME155133207RH0003X
FL155133208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology