Provider Demographics
NPI:1053931022
Name:AMAYA LOPEZ, FLOR DE MARIA
Entity type:Individual
Prefix:
First Name:FLOR
Middle Name:DE MARIA
Last Name:AMAYA 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 1:147 CLARK AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-2176
Mailing Address - Country:US
Mailing Address - Phone:857-928-6564
Mailing Address - Fax:
Practice Address - Street 1:147 CLARK AVE APT 2
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2176
Practice Address - Country:US
Practice Address - Phone:857-928-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA767197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist