Active NPI
Jose Lopez
- Radiography Radiologic Technologist
- Tampa, FL
National Provider Identifier
1063668002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiography Radiologic Technologist
- License
- BMO72850
- Practice address
- 3105 W Waters Ave Ste 304
Tampa, FL 33614-2872 - Phone
- (813) 933-4506
- NPI assigned
- Aug 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA53981 | FL | |
| Radiography Radiologic Technologist | 2471C3402X | BMO72850 | FL | Primary |
Addresses
Primary practice location
3105 W Waters Ave Ste 304
Tampa, FL 33614-2872
Mailing address
3105 W Waters Ave Ste 304
Tampa, FL 33614-2872
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA53981 | FL | MD | Massage Therapist |
| BMO72850 | FL | MD | Radiography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236297600000",
"number": "1063668002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3105 W WATERS AVE STE 304",
"city": "TAMPA",
"state": "FL",
"postal_code": "336142872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3105 W WATERS AVE STE 304",
"city": "TAMPA",
"state": "FL",
"postal_code": "336142872",
"telephone_number": "813-933-4506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "JOSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-11",
"last_updated": "2009-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA53981",
"primary": false
},
{
"code": "2471C3402X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiography",
"state": "FL",
"license": "BMO72850",
"primary": true
}
],
"identifiers": [],
"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 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.