Active NPI
Rene Luis Lopez-Guerrero, M.D.
- Pediatrics Physician
- Miami, FL
National Provider Identifier
1104824077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME0049266
- Practice address
- 3100 SW 62ND Ave
Miami, FL 33155-3009 - Phone
- (305) 643-0133
- Fax
- (305) 643-1728
- NPI assigned
- Jul 13, 2005
- Reactivated
- Mar 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | ME0049266 | FL | |
| Pediatrics Physician | 208000000X | ME0049266 | FL | Primary |
Addresses
Primary practice location
3100 SW 62ND Ave
Miami, FL 33155-3009
Mailing address
3100 SW 62ND Ave
Miami, FL 33155-3009
Phone (305) 643-0133
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046697200 | Medicaid | FL |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0049266 | FL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551225600000",
"number": "1104824077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SW 62ND AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331553009",
"telephone_number": "305-643-0133",
"fax_number": "305-643-1728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 SW 62ND AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331553009",
"telephone_number": "305-643-0133",
"fax_number": "305-643-1728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ-GUERRERO",
"first_name": "RENE",
"middle_name": "LUIS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-13",
"last_updated": "2019-02-27",
"deactivation_date": "2006-03-17",
"reactivation_date": "2006-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "FL",
"license": "ME0049266",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME0049266",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "046697200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.