Organization Active NPI

Davina Medical Care, P.a.

  • Family Medicine Physician
  • Homestead, FL
National Provider Identifier
1053363697
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME84057 Issued in FL
Legal business name
DAVINA MEDICAL CARE, P.A.
Practice address
151 NW 11TH St
Suite: E-304
Homestead, FL 33030-4360
Phone
(305) 245-8787
Fax
(305) 245-8778
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Luisa M Lopez-Luciano, M.D.NPI 1558313627
Title
Doctor
Phone
(305) 245-8787

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X ME84057 FL Primary

Addresses

Primary practice location

151 NW 11TH St
Suite: E-304
Homestead, FL 33030-4360

Mailing address

151 NW 11TH St
Suite: E-304
Homestead, FL 33030-4360
Phone (305) 245-8787

Other identifiers 1

IdentifierTypeStateIssuer
ME84057OtherFLME #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060629000268 FL Part B Supplier - Clinic/Group Practice 7517979982 Receives reassigned benefits from 2 practitioners
Practice locations: Homestead, FL

National Provider Directory

National Provider Directory

Locations

151 NW 11th St
Ste E304
Homestead, FL 33030
Phone (305) 245-8787

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDJHBD

Practitioners & affiliated clinicians

Practitioners 2

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": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1053363697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 NW 11TH ST",
            "address_2": "SUITE: E-304",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304360",
            "telephone_number": "305-245-8787",
            "fax_number": "305-245-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 NW 11TH ST",
            "address_2": "SUITE: E-304",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304360",
            "telephone_number": "305-245-8787",
            "fax_number": "305-245-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVINA MEDICAL CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "LOPEZ-LUCIANO",
        "authorized_official_first_name": "LUISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "305-245-8787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME84057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ME #",
            "identifier": "ME84057",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.