Active NPI
Jose Valentin Padilla-Lopez, M.D.
- Pediatrics Physician
- Fort Myers, FL
National Provider Identifier
1366400434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME60087
- Practice address
- 13650 Metropolis Avenue
Suite 101
Fort Myers, FL 33912 - Phone
- (239) 768-2111
- Fax
- (239) 768-2113
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME60087 | FL | Primary |
Addresses
Primary practice location
13650 Metropolis Avenue
Suite 101
Fort Myers, FL 33912
Mailing address
12550 Professional Park Drive
Suite 11
Fort Myers, FL 33913
Phone (239) 768-2111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 054789100 | Medicaid | FL |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME60087 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Island Coast Pediatrics | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- jpadilla@icpeds.opdirect.net
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.
-
- Pediatrics Physician
- Fort Myers, FL
- NPI 1215962386
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376438400000",
"number": "1366400434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12550 PROFESSIONAL PARK DRIVE",
"address_2": "SUITE 11",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33913",
"telephone_number": "239-768-2111",
"fax_number": "239-482-4404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13650 METROPOLIS AVENUE",
"address_2": "SUITE 101",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33912",
"telephone_number": "239-768-2111",
"fax_number": "239-768-2113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADILLA-LOPEZ",
"first_name": "JOSE",
"middle_name": "VALENTIN",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2013-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME60087",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "054789100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.