Juan Pablo Lopez Gonzalez, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

16911 Issued in PR

Practice address

34490 Cortez Blvd
Ridge Manor, FL 33523-8908

Phone

(352) 583-4520

NPI assigned

Nov 28, 2007

Last updated

May 22, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Healthflo Medical Clinics Inc

  dba Ridge Manor Medical Clinic

  • Rural Health Clinic/Center
  • Ridge Manor, FL
  • NPI 1164568275
  Medicare reassignment NPD
• Healthflo Medical Clinics Inc

  dba Bushnell Family Practice

  • Rural Health Clinic/Center
  • Bushnell, FL
  • NPI 1255477360
  NPD
• Healthflo Medical Clinics, Inc.

  dba Wesley Chapel Medical Clinic

  • Clinic/Center
  • Wesley Chapel, FL
  • NPI 1184760290
  NPD

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1225210685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34490 CORTEZ BLVD",
            "city": "RIDGE MANOR",
            "state": "FL",
            "postal_code": "335238908",
            "telephone_number": "352-583-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34490 CORTEZ BLVD",
            "city": "RIDGE MANOR",
            "state": "FL",
            "postal_code": "335238908",
            "telephone_number": "352-583-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ GONZALEZ",
        "first_name": "JUAN",
        "middle_name": "PABLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICINE LICENSE",
            "identifier": "16911",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Healthflo Medical Clinics Inc (Ridge Manor Medical Clinic)
• Heidi Lutz LLC
• Kerry Hernandez
• Joseph Janiczek, LMT
• Brittany Maria Johnson, M.S. ITDS
• Thomas Ostrander II, LPN
• Ridge Manor Pharmacy (Benzer Pharmacy Ridge Manor)
• Nikki Jane Riegel, FNP-C
• Ana Maria Rodriguezperez
• Sunridge Ministries, Inc

• General Practice Physician in Ridge Manor, FL
• Providers in Ridge Manor, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.