Provider Demographics
NPI:1447079736
Name:FERNANDEZ LOPEZ, YUSMARY
Entity type:Individual
Prefix:
First Name:YUSMARY
Middle Name:
Last Name:FERNANDEZ LOPEZ
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 1:201 BONNIE BLVD APT 111
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-1317
Mailing Address - Country:US
Mailing Address - Phone:561-298-4944
Mailing Address - Fax:
Practice Address - Street 1:201 BONNIE BLVD APT 111
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-1317
Practice Address - Country:US
Practice Address - Phone:561-298-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI58292355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant