Individual provider Active NPI

Arturo Fernandez Lopez, PAC

  • Physician Assistant
  • Doral, FL
National Provider Identifier
1407136971
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106113 Issued in FL
Practice address
2000 NW 87TH Ave Ste 101-102
Doral, FL 33172-2654
Phone
(305) 189-1387
NPI assigned
Aug 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9106113 FL Primary

Addresses

Primary practice location

2000 NW 87TH Ave Ste 101-102
Doral, FL 33172-2654

Mailing address

2000 NW 87TH Ave Ste 101-102
Doral, FL 33172-2654
Phone (786) 506-3551

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111222000429 FL Practitioner - Physician Assistant 5092981050 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9106113FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Guidewell Sanitas I, LLC CurrentSince Jan 9, 2020 Accepting new patients
Wayne H Case MD PA Past Accepting new patients
Family Medical Centre Past Accepting new patients

Locations

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

Organizations & group practices 4

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": "1314403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1407136971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NW 87TH AVE STE 101-102",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722654",
            "telephone_number": "786-506-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NW 87TH AVE STE 101-102",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722654",
            "telephone_number": "305-189-1387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ LOPEZ",
        "first_name": "ARTURO",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-27",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.