Yusupova Lopez, Iryna

Yusupova Lopez, Iryna is an sole proprietor health care provider with primary practice located at 3261 Us Hwy 441 Unit B3 , Fruitland Park FL 34731. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Agencies / Early Intervention Provider Agency. Agencies / Early Intervention Provider Agency is her primary health care specialty. Yusupova Lopez, Iryna can be contacted via phone (352) 323-0612.

Contact Information

Primary practice address
3261 Us Hwy 441 Unit B3 Fruitland Park FL 34731
Phone: (352) 323-0612
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Agencies / Early Intervention Provider Agency 252Y00000X

Profile Details

NPI number 1326191982
LBN Legal business name Yusupova Lopez, Iryna
Credentials M.A., ITDS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 18th, 2007
Last updated Nov 29th, 2021 - about 3 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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Identifiers

StateTypeNumberIssuer
All States NPI 1326191982 NPPES
Florida MEDICAID 811804300

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