Individual provider Active NPI

Raymond A Lopez, M.D.

  • Obstetrics & Gynecology Physician
  • Miramar, FL
National Provider Identifier
1083708747
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME130127 Issued in FL
Practice address
4064 SW 69TH Ave
Miramar, FL 33023-6688
Phone
(542) 398-8609
Fax
(954) 239-8847
NPI assigned
Oct 3, 2006
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME130127 FL
Adult Medicine Physician 207QA0505X ME130127 FL
Obstetrics & Gynecology Physician 207V00000X 18239 AL
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X ME130127 FL Primary

Addresses

Primary practice location

4064 SW 69TH Ave
Miramar, FL 33023-6688

Mailing address

16900 North Bay Rd 2217
Sunny Isles, FL 33160-6274
Phone (256) 508-9002

Other practice location 1

3809 Sullivan St
Suite 6-A
Madison, AL 35758-2372
Phone (256) 461-4104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100914001059 AL Practitioner - Obstetrics/Gynecology 1254392608
I20210810002933 FL Practitioner - Obstetrics/GynecologyPractitioner - Family Practice 1254392608 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Family Practice
Education
Ponce School of Medicine, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Ultrahealth L.L.C.Group PAC ID 4688037401, 5 clinicians

Practice addresses (Care Compare)

4064 SW 69TH Ave
Miramar, FL 33023-6688
Phone (954) 239-8847

5038 Coronado Pkwy
Naples, FL 34116-6950
Phone (239) 499-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Retreat Medical Center LLC Multi-Specialty CurrentSince Jun 30, 2025 Accepting new patients
North Alabama Obstetrics and Gynecology Multi-Specialty CurrentSince Aug 23, 1999 Accepting new patients
Somos Vida Medical Center, LLC Multi-Specialty CurrentSince May 6, 2021 Accepting new patients
Ultrahealth, L.L.C. Multi-Specialty CurrentSince Apr 1, 2025 Accepting new patients
Roy Sleep Medicine Inc Multi-Specialty Past Accepting new patients

Locations

3809 Sullivan St
Ste 6A
Madison, AL 35758
Phone (256) 213-1800

4910 E 2nd Ave
Hialeah, FL 33013
Phone (305) 400-9454

228 Plaza Dr
Ste D
Lehigh Acres, FL 33936
Phone (239) 491-8204

1818 W Flagler St
Miami, FL 33135
Phone (754) 208-9566

1818 W Flagler St
Ste 300
Miami, FL 33135
Phone (786) 755-2891

4064 SW 69th Ave
Miramar, FL 33023
Phone (954) 239-8847

5038 Coronado Pkwy
Naples, FL 34116
Phone (239) 234-6835

6400 Davis Blvd
Ste 103
Naples, FL 34104
Phone (239) 304-0054

2003 McCoy Rd
Ste C
Orlando, FL 32809
Phone (239) 499-0900

Interoperability endpoints

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1083708747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16900 NORTH BAY RD 2217",
            "city": "SUNNY ISLES",
            "state": "FL",
            "postal_code": "331606274",
            "telephone_number": "256-508-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4064 SW 69TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330236688",
            "telephone_number": "542-398-8609",
            "fax_number": "954-239-8847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3809 Sullivan St",
            "address_2": "Suite 6-A",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "AL",
            "postal_code": "357582372",
            "country_code": "US",
            "telephone_number": "256-461-4104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "RAYMOND",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME130127",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME130127",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "18239",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME130127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.