Individual provider Active NPI

Lucero Lopez, OTR/L

  • Contractor
  • Miami Lakes, FL
National Provider Identifier
1417129735
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
8644 Issued in FL
Practice address
15010 Dunbarton PL
Miami Lakes, FL 33016-1417
Phone
(305) 820-5011
NPI assigned
Mar 26, 2008
Last updated
Mar 26, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 8644 FL Primary

Addresses

Primary practice location

15010 Dunbarton PL
Miami Lakes, FL 33016-1417

Mailing address

15010 Dunbarton PL
Miami Lakes, FL 33016-1417
Phone (305) 820-5011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041203000603 FL Practitioner - Occupational Therapist in Private Practice 5092771840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bolanos Associates, LLC.Group PAC ID 0840327342, 16 clinicians

Practice addresses (Care Compare)

1150 NW 72ND Ave
Suite 720
Miami, FL 33126-1932
Phone (866) 693-0181

7340 NW 5TH St
Plantation, FL 33317-1605
Phone (786) 259-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8644FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
RB Cypress Rehab Center, Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1417129735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15010 DUNBARTON PL",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161417",
            "telephone_number": "305-820-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15010 DUNBARTON PL",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161417",
            "telephone_number": "305-820-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "LUCERO",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "FL",
            "license": "8644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.