Jacqueline Lopez, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

6520 Issued in FL

Practice address

3062 Dyer Blvd
Kissimmee, FL 34741-7839

Phone

(407) 343-6228

NPI assigned

Jul 2, 2024

Last updated

Jul 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Treyefecta Vision Holdings, LLC

  • Optometrist
  • Tampa, FL
  • NPI 1255707683
  Medicare reassignment NPD

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1083450829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7928 S MARBELLA CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328368707",
            "telephone_number": "321-297-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3062 DYER BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417839",
            "telephone_number": "407-343-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "6520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Lopez Jr.
• Blanca Lopez, PTA
• Chariz M Lopez
• Eduardo Lopez, ARNP
• Gina E Lopez, M.ED
• Jasmine Rosalyn Lopez
• Leslie Lopez
• Lorena Lopez
• Marcos Lopez
• Marianne Lopez

• Optometrist in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.