Organization Active NPI

Gloria Lopez MD PA

  • Pediatrics Physician
  • Coral Gables, FL
National Provider Identifier
1366814568
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
38886 Issued in FL
Legal business name
GLORIA LOPEZ MD PA
Practice address
747 Ponce de Leon Blvd Ste 603
Coral Gables, FL 33134-2074
Phone
(305) 443-2324
Fax
(305) 290-3180
NPI assigned
Oct 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Authorized official

Name
Gloria Lopez, MDNPI 1487757001
Title
Owner
Phone
(305) 443-2324

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 38886 FL Primary

Addresses

Primary practice location

747 Ponce de Leon Blvd Ste 603
Coral Gables, FL 33134-2074

Mailing address

747 Ponce de Leon Blvd Ste 603
Coral Gables, FL 33134-2074
Phone (305) 443-2324

Other identifiers 1

IdentifierTypeStateIssuer
376045600MedicaidFL

National Provider Directory

National Provider Directory

Locations

747 Ponce de Leon Blvd
Ste 603
Coral Gables, FL 33134
Phone (305) 443-2324

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1366814568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 PONCE DE LEON BLVD STE 603",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342074",
            "telephone_number": "305-443-2324",
            "fax_number": "305-290-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 PONCE DE LEON BLVD STE 603",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342074",
            "telephone_number": "305-443-2324",
            "fax_number": "305-290-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORIA LOPEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-27",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-443-2324",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "38886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376045600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.