Lopez, Ivan Ricardo

Lopez, Ivan Ricardo is an individual health care provider with primary practice located at 11033 Nw State Road 20 , Bristol FL 32321-6406. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Lopez, Ivan Ricardo can be contacted via phone (850) 643-1155.

Contact Information

Primary practice address
11033 Nw State Road 20 Bristol FL 32321-6406
Phone: (850) 643-1155
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 16852 Florida

Profile Details

NPI number 1164058756
LBN Legal business name Lopez, Ivan Ricardo
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2020
Last updated Mar 16th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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