Organization Active NPI

Rossana Lopez MD PA

  • Internal Medicine Physician
  • Hialeah, FL
National Provider Identifier
1013262377
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME64156 Issued in FL
Legal business name
ROSSANA LOPEZ MD PA
Practice address
777 E 25TH St
Suite 516
Hialeah, FL 33013-3825
Phone
(305) 836-1696
Fax
(305) 836-1698
NPI assigned
Jul 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Authorized official

Name
Dr. Rossana Lopez, MDNPI 1326159385
Title
Owner
Phone
(305) 836-1696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME64156 FL Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X ME64156 FL

Addresses

Primary practice location

777 E 25TH St
Suite 516
Hialeah, FL 33013-3825

Mailing address

3511 SW 100TH Ave
Miami, FL 33165-3846
Phone (305) 836-1696

Other identifiers 1

IdentifierTypeStateIssuer
374037400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121101000193 FL Part B Supplier - Clinic/Group Practice 5294985032 Receives reassigned benefits from 1 practitioner
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory

Locations

600 E 25th St
Ste A
Hialeah, FL 33013
Phone (305) 836-1696

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1013262377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 SW 100TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653846",
            "telephone_number": "305-836-1696",
            "fax_number": "305-647-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST",
            "address_2": "SUITE 516",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133825",
            "telephone_number": "305-836-1696",
            "fax_number": "305-836-1698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSSANA LOPEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ROSSANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-836-1696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME64156",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME64156",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374037400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.