| Doctor Name: | MARIA LOPEZ |
| NPI Number: | 1124088133 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | ME86776 |
| Business Practice Address: | 305 Memorial Medical Pkwy Suite 303 Daytona Beach, FL - 321175168 |
| Business Phone Number: | 3866158909 |
| Business Fax Number: | 3866158910 |
| Mailing Address: | Po Box 731138, ORMOND BEACH |
| State: | FL |
| Postal Code: | 321731138 |
| Phone Number: | 3866728101 |
| Fax Number: | 3866728102 |
| NPI Enumeration Date: | 03/24/2006 |
| NPI Last Update Date: | 11/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | ME86776 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |