Provider Demographics
NPI:1861208274
Name:MERCEDLOPEZ, FLORIBEL
Entity type:Individual
Prefix:
First Name:FLORIBEL
Middle Name:
Last Name:MERCEDLOPEZ
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 1:2871 NAMIB DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80939-9721
Mailing Address - Country:US
Mailing Address - Phone:720-363-7705
Mailing Address - Fax:
Practice Address - Street 1:2871 NAMIB DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80939-9721
Practice Address - Country:US
Practice Address - Phone:720-363-7705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter