Provider Demographics
NPI:1417583782
Name:LOPEZ RODRIGUEZ, VERONICA (PHD, MRC)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:LOPEZ RODRIGUEZ
Suffix:
Gender:F
Credentials:PHD, MRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2544 WILD HOLLYHOCK DR APT 3414
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-6879
Mailing Address - Country:US
Mailing Address - Phone:787-420-2181
Mailing Address - Fax:
Practice Address - Street 1:2544 WILD HOLLYHOCK DR APT 3414
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-6879
Practice Address - Country:US
Practice Address - Phone:787-420-2181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2025-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1720225C00000X
FLPY12885103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor