Ivelisse Socorro Lopez, P.T.

NPI #1013055979 in Jacksonville, Florida

Provider Information

NPI Number: 1013055979
Entity Type: Individual
Name: Ivelisse Socorro Lopez, P.T.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: P.T.
Enumeration Date: Feb 2, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 3901 UNIVERSITY BLVD S
City: Jacksonville
State: Florida
ZIP Code: 32216-4312
Phone: (904) 858-7200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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