Individual provider Active NPI

Gabriela Sofia Lopez Cohen, MD

  • Family Medicine Physician
  • Haines City, FL
National Provider Identifier
1093482549
Registry record updated Jan 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME167626 Issued in FL
Practice address
36245 US Hwy 27 N
Haines City, FL 33844-3744
Phone
(863) 421-9801
NPI assigned
Aug 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME167626 FL Primary

Addresses

Primary practice location

36245 US Hwy 27 N
Haines City, FL 33844-3744

Mailing address

36245 US Hwy 27 N
Haines City, FL 33844-3744
Phone (863) 421-9801

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240617001844 FL Practitioner - Family Practice 5092258228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

Hospital & facility affiliations

  • Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Jun 10, 2024 Accepting new patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Jun 10, 2024 Accepting new patients
Mid-Florida Interventional Cardiology Physician Services LLC PastSince Feb 16, 2025 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

36245 US Hwy 27 N
Haines City, FL 33844
Phone (863) 421-9801

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737158400000",
    "number": "1093482549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36245 US HWY 27 N",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338443744",
            "telephone_number": "863-421-9801",
            "fax_number": "863-229-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36245 US HWY 27 N",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338443744",
            "telephone_number": "863-421-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ COHEN",
        "first_name": "GABRIELA",
        "middle_name": "SOFIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME167626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haines City, FL

Sources for this page

Verify at the official NPI Registry.