Active NPI
Eric Lup-Sing Lo M. D., P.a.
- Cardiovascular Disease Physician
- Daytona Beach, FL
National Provider Identifier
1033635271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- ERIC LUP-SING LO M. D., P.A.
- Practice address
- 305 Memorial Medical Pkwy
Daytona Beach, FL 32117-5168 - Phone
- (386) 672-1023
- Fax
- (386) 263-2996
- NPI assigned
- Aug 18, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Yvette S Anderson
- Title
- Consulting Manager
- Phone
- (386) 316-0955
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | FL | Primary |
Addresses
Primary practice location
305 Memorial Medical Pkwy
Daytona Beach, FL 32117-5168
Mailing address
305 Memorial Medical Pkwy
Daytona Beach, FL 32117-5168
Phone (386) 672-1023
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8346100 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
325 Clyde Morris Blvd
Ste 300
Ormond Beach, FL 32174
Phone (386) 304-3404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503014400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1033635271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 MEMORIAL MEDICAL PKWY",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321175168",
"telephone_number": "386-672-1023",
"fax_number": "386-263-2996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 MEMORIAL MEDICAL PKWY",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321175168",
"telephone_number": "386-672-1023",
"fax_number": "386-263-2996"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ERIC LUP-SING LO M. D., P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2017-08-18",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "ANDERSON",
"authorized_official_first_name": "YVETTE",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "CONSULTING MANAGER",
"authorized_official_telephone_number": "386-316-0955"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8346100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.