Organization Active NPI

Lourdes Loreto MD PA

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1013108984
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME29045 Issued in FL
Legal business name
LOURDES LORETO MD PA
Practice address
4710 N Habana Ave
202
Tampa, FL 33614
Phone
(813) 877-3902
Fax
(813) 877-3807
NPI assigned
Aug 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lourdes Loreto, MD
Title
Physician
Phone
(813) 877-3902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME29045 FL Primary

Addresses

Primary practice location

4710 N Habana Ave
202
Tampa, FL 33614

Mailing address

4710 N Habana Ave
202
Tampa, FL 33614
Phone (813) 877-3902

Other identifiers 3

IdentifierTypeStateIssuer
057966100MedicaidFL
29972OtherFLBLUE CROSS BLUE SHIELD
407112745OtherFLRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

4710 N Habana Ave
Ste 202
Tampa, FL 33614
Phone (813) 803-9111

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1013108984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 N HABANA AVE",
            "address_2": "202",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33614",
            "telephone_number": "813-877-3902",
            "fax_number": "813-877-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 N HABANA AVE",
            "address_2": "202",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33614",
            "telephone_number": "813-877-3902",
            "fax_number": "813-877-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOURDES LORETO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "LORETO",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "813-877-3902",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME29045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057966100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "29972",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "407112745",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.