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Dr. Yvette Marie Lopez-Granberry

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NPI Number Detailed Information

Provider Information:

Name: Dr. Yvette Marie Lopez-Granberry
Gender: F
Provider License Number If Given: ME59258

NPI Information:

NPI: 1750384772
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 3/22/2013

Provider Business Mailing Address:

Address: 456 PRESTWICK CT
Melbourne, FL 32940
Phone Number: 3212542016
Fax Number:

Provider Business Practice Location Address:

Address: 6300 N WICKHAM RD STE 101
Melbourne, FL 32940
Phone Number: 3212532169
Fax Number: 3212531720

Provider Taxonomy:

Primary: 207R00000X
Secondary (if any):
State: FL

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