Individual provider Active NPI

Heather Lopez

  • Family Nurse Practitioner
  • Winter Haven, FL
National Provider Identifier
1205411998
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11012093 Issued in FL
Practice address
1110 Citrus LN
Winter Haven, FL 33884-3682
Phone
(863) 978-8737
Fax
(614) 350-5011
NPI assigned
Mar 14, 2021
Last updated
Jul 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11012093 FL Primary

Addresses

Primary practice location

1110 Citrus LN
Winter Haven, FL 33884-3682

Mailing address

1025 Margot LN
Lake Wales, FL 33853-2732
Phone (863) 488-6827

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL LakeWales Other

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210318000059 FL Practitioner - Nurse Practitioner 0143637140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Practitioner Services LLCGroup PAC ID 7214392810, 31 clinicians

Practice addresses (Care Compare)

6547 Kenava Loop
Palmetto, FL 34221-2595
Phone (941) 218-0175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11012093FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Practitioner Services LLC Single Specialty CurrentSince Nov 1, 2025 Accepting new patients

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, 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": "1615680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1205411998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MARGOT LN",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338532732",
            "telephone_number": "863-488-6827",
            "fax_number": "614-350-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 CITRUS LN",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843682",
            "telephone_number": "863-978-8737",
            "fax_number": "614-350-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "HEATHER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-14",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11012093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "LakeWales",
            "affiliation": "N",
            "endpointDescription": "any",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "If needed",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "None",
            "address_1": "1025 Margot Ln",
            "city": "Lake Wales",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338532732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.