Active NPI
Gisell Estrella Lopez, PSY.D.
- Clinical Psychologist
- Pembroke Pines, FL
National Provider Identifier
1790048973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY8529
- Practice address
- 1111 SW 85TH Ave
Pembroke Pines, FL 33025-3353 - Phone
- (786) 471-6980
- NPI assigned
- Jun 21, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY8529 | FL | Primary |
Addresses
Primary practice location
1111 SW 85TH Ave
Pembroke Pines, FL 33025-3353
Mailing address
1111 SW 85TH Ave
Pembroke Pines, FL 33025-3353
Phone (786) 471-6980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY8529 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1790048973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 SW 85TH AVE",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330253353",
"telephone_number": "786-471-6980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 SW 85TH AVE",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330253353",
"telephone_number": "786-471-6980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "GISELL",
"middle_name": "ESTRELLA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-21",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY8529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.