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Contact Information

IVAN LOPEZLLAVORE, PTA
3011 SABAL BEND DR NE
WINTER HAVEN, FL33881-5108
 Phone: 863-651-3040
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Home Administrator

376G00000X
 

Physical Therapy Assistant

225200000X
Indicates primary specialty

NPI Profile & details for IVAN LOPEZLLAVORE · (Male)

NPI # 1740419225
Status Active
Credentials PTA (Physical Therapist Assistant)
Entity Individual
Enumeration date 07/06/2009
Last updated 09/20/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • FL License # NH4843
  • FL License # PTA20203
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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