Provider Demographics
NPI:1679808786
Name:POPE, HOPE ALICIA (LMT)
Entity type:Individual
Prefix:MRS
First Name:HOPE
Middle Name:ALICIA
Last Name:POPE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16210 SE 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-5338
Mailing Address - Country:US
Mailing Address - Phone:352-303-6692
Mailing Address - Fax:352-307-3790
Practice Address - Street 1:16210 SE 73RD AVE
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-5338
Practice Address - Country:US
Practice Address - Phone:352-303-6692
Practice Address - Fax:352-307-3790
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 55963173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist