Individual provider Active NPI

Agustin Rodolfo Lopez Leiros, RPH

  • Family Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1235574484
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11023966 Issued in FL
Practice address
1631 Del Prado Blvd S Ste 300
Cape Coral, FL 33990-6740
Phone
(786) 577-2018
Fax
(786) 957-5158
NPI assigned
May 1, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS47176 FL
Registered Nurse 163W00000X RN9574671 FL
Family Nurse Practitioner 363LF0000X APRN11023966 FL Primary

Addresses

Primary practice location

1631 Del Prado Blvd S Ste 300
Cape Coral, FL 33990-6740

Mailing address

4102 NW 39TH St
Cape Coral, FL 33993-7853
Phone (786) 577-2018

Other practice location 1

1930 Kings Hwy
Port Charlotte, FL 33980-4214
Phone (941) 764-8444

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RN9574671FLMDRegistered Nurse
PS47176FLMDPharmacist
APRN11023966FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Sunset Healthcare Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1235574484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 NW 39TH ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339937853",
            "telephone_number": "786-577-2018",
            "fax_number": "786-957-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 DEL PRADO BLVD S STE 300",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339906740",
            "telephone_number": "786-577-2018",
            "fax_number": "786-957-5158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339804214",
            "country_code": "US",
            "telephone_number": "941-764-8444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ LEIROS",
        "first_name": "AGUSTIN",
        "middle_name": "RODOLFO",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-01",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS47176",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9574671",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11023966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.