Individual provider Active NPI

Fabian Velazquez Lopez

  • Family Medicine Physician
  • Ceiba, PR
National Provider Identifier
1194766105
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5071 Issued in PR
Practice address
288 Ave Lauro Pinero
Ceiba, PR 00735-2706
Phone
(787) 885-3525
Fax
(787) 885-3525
NPI assigned
Jun 9, 2006
Last updated
May 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5071 PR Primary
General Practice Physician 208D00000X 5071 PR

Addresses

Primary practice location

288 Ave Lauro Pinero
Ceiba, PR 00735-2706

Mailing address

288 Ave Lauro Pinero
Ceiba, PR 00735-2706
Phone (787) 885-3525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20120522001166 PR Practitioner - General Practice 6800059288 Practice locations: Ceiba, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Ave Lauro Pinero
Suite 288
Ceiba, PR 00735-2706
Phone (787) 885-3525

Ave Lauro Pinero Num
Suite 288
Ceiba, PR 00735-2706

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1194766105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 AVE LAURO PINERO",
            "city": "CEIBA",
            "state": "PR",
            "postal_code": "007352706",
            "telephone_number": "787-885-3525",
            "fax_number": "787-885-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 AVE LAURO PINERO",
            "city": "CEIBA",
            "state": "PR",
            "postal_code": "007352706",
            "telephone_number": "787-885-3525",
            "fax_number": "787-885-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ LOPEZ",
        "first_name": "FABIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "5071",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "5071",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ceiba, PR

Sources for this page

Verify at the official NPI Registry.