Individual provider Active NPI

Jenette Teresa Lopez-Nunes, MD

  • Internal Medicine Physician
  • Melbourne, FL
National Provider Identifier
1417903253
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0074256 Issued in FL
Practice address
2900 Veterans Way
Melbourne, FL 32940-8007
Phone
(321) 637-3788
NPI assigned
May 25, 2006
Last updated
Dec 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0074256 FL Primary

Addresses

Primary practice location

2900 Veterans Way
Melbourne, FL 32940-8007

Mailing address

2900 Veterans Way
Melbourne, FL 32940-8007
Phone (321) 637-3788

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101215000171 FL Practitioner - Internal Medicine 9335336460 Practice locations: Viera, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0074256FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291161600000",
    "number": "1417903253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 VETERANS WAY",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408007",
            "telephone_number": "321-637-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 VETERANS WAY",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408007",
            "telephone_number": "321-637-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-NUNES",
        "first_name": "JENETTE",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2010-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0074256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.