| Doctor Name: | LINO LOPEZ |
| NPI Number: | 1003884453 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NP |
| License Number: | NP3256922 |
| Business Practice Address: | 550 E. Dixie Avenue Lrmc Urgent Care Leesburg, FL - 34748 |
| Business Phone Number: | 3523232273 |
| Business Fax Number: | |
| Mailing Address: | 36537 Barrington Dr, EUSTIS |
| State: | FL |
| Postal Code: | 327368741 |
| Phone Number: | 3523571341 |
| Fax Number: | |
| NPI Enumeration Date: | 03/10/2006 |
| NPI Last Update Date: | 10/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP3256922 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |