Organization Active NPI

Eric Lup-Sing Lo M. D., P.a.

  • Cardiovascular Disease Physician
  • Daytona Beach, FL
National Provider Identifier
1033635271
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
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

Updated by the provider on Jul 21, 2022

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)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
8346100MedicaidFL

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.