Jose Luis Lopez
Individual provider Active NPI Non-emergency Medical Transport (VAN) · Fort White, FL
NPI 1255895348 · NPPES record last updated Jan 23, 2019
Key facts
- NPI
- 1255895348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Non-emergency Medical Transport (VAN) 343900000X
- Practice address
- 6459 SW County Road 18 Unit 4
Fort White, FL 32038-3464 - Phone
- (352) 474-9788
- NPI assigned
- Jan 23, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caring Wheels Transportation LLC | Non-Emergency Medical Transport (Van) | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-emergency Medical Transport (VAN) | 343900000X | FL | Yes |
Addresses
Primary practice location
6459 SW County Road 18 Unit 4
Fort White, FL 32038-3464
Mailing address
504 SW Bucchi GLN
Fort White, FL 32038-2936
Phone (352) 474-9788
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 474115030 | Medicaid | FL |
Other providers in Fort White, FL
- Lucille Idarola
- Ja'Chari Johnson
- Susan Virginia Koontz
- Jessica Land
- Marion M Landua-Figueroa
- Carly Malin
- Maria'S Support Coordination LLC
- Dianne Marroletti
- Kathleen Marshall
- Kaleah McCoy
All providers in Fort White, FL · Non-emergency Medical Transport (VAN) in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.