Individual provider Active NPI

Julio E Lopez Andujar, MD

  • Internal Medicine Physician
  • Hialeah, FL
National Provider Identifier
1104921568
Registry record updated Dec 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME63486 Issued in FL
Practice address
975 W 49TH St
Hialeah, FL 33012-3412
Phone
(305) 827-2002
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME63486 FL Primary

Addresses

Primary practice location

975 W 49TH St
Hialeah, FL 33012-3412

Mailing address

6101 Blue Lagoon Dr Ste 400
Miami, FL 33126-2051
Phone (305) 500-2000

Other identifiers 1

IdentifierTypeStateIssuer
373920100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address julio.lopezandujar@conviva.eclinicaldirectplus.com Direct

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
I20051008000188 FL Practitioner - Internal Medicine 6406871474 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME63486FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients

Locations

440 W 49th St
Hialeah, FL 33012
Phone (305) 828-5000

975 W 49th St
Hialeah, FL 33012
Phone (305) 512-9381

6101 Blue Lagoon Dr
Ste 400
Miami, FL 33126
Phone (305) 500-2114

1200 SW 1st St
Miami, FL 33135
Phone (305) 324-2000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638576000000",
    "number": "1104921568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262051",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 W 49TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123412",
            "telephone_number": "305-827-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ ANDUJAR",
        "first_name": "JULIO",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2021-12-04",
        "certification_date": "2021-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME63486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373920100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "julio.lopezandujar@conviva.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "975 W 49th St",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330123412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.