Provider Demographics
NPI:1295582427
Name:LOPEZ FIGUEREDO, SHANDOR (FNP)
Entity type:Individual
Prefix:
First Name:SHANDOR
Middle Name:
Last Name:LOPEZ FIGUEREDO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 NW 186TH ST APT 103
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3318
Mailing Address - Country:US
Mailing Address - Phone:305-301-9009
Mailing Address - Fax:
Practice Address - Street 1:6700 NW 186TH ST APT 103
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3318
Practice Address - Country:US
Practice Address - Phone:305-301-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11032620363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily