Lopez, Jackeline
Lopez, Jackeline is an sole proprietor health care provider with primary practice located at 801 E Dixie Ave Ste 101 , Leesburg FL 34748-7601. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Lopez, Jackeline can be contacted via phone (352) 326-4031.Contact Information
Primary practice address
801 E Dixie Ave Ste 101
Leesburg FL 34748-7601
Phone: (352) 326-4031
Fax: (352) 360-0257
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 21359 | Puerto Rico |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | ACN1303 | Florida |
Profile Details
| NPI number | 1073174496 |
|---|---|
| LBN Legal business name | Lopez, Jackeline |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 26th, 2019 |
| Last updated | Jan 11th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073174496 | NPPES |
| Florida | MEDICAID | 109164100 |
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