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Dr. Jackeline Lopez
General Practice Physician in Leesburg, Florida
NPI 1073174496

Jackeline Lopez is a General Practice Physician based in Leesburg, FL. Jackeline Lopez practices in Leesburg, FL. The NPI Number for Jackeline Lopez is 1073174496 and holds a License No. 21359 (Florida).

The current practice location address for Jackeline Lopez is 801 E Dixie Ave Ste 101, Leesburg, FL and can be reached out via phone at 352-326-4031 and via fax at 352-360-0257.

Location: 801 E Dixie Ave Ste 101, Leesburg, FL, 34748-7601
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073174496
Provider Name
Jackeline Lopez
Credential
Provider Entity Type
Individual
Gender
Female
Address
801 E Dixie Ave Ste 101, Leesburg, FL, 34748-7601
Phone Number
352-326-4031
Fax Number
352-360-0257
Provider Enumeration Date
06/26/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
109164100 05 FL
institution
Provider Business Practice Location Address Details
Address
801 E Dixie Ave Ste 101
City
Leesburg
State
Florida
Zip
34748-7601
Phone Number
352-326-4031
Fax Number
352-360-0257
person
Provider Business Mailing Address Details
Address
801 E Dixie Ave Ste 101
City
Leesburg
State
Florida
Zip
34748-7601
Phone Number
352-326-4031
Fax Number
352-360-0257
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
21359 ()
Definition
Definition to come...
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