Individual provider Active NPI

Viviana Del C. Lopez, O.D.

  • Optometrist
  • Kissimmee, FL
National Provider Identifier
1447583950
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4500 Issued in FL
Practice address
1028 E Osceola Pkwy
Kissimmee, FL 34744-1607
Phone
(407) 483-5906
Fax
(407) 483-5908
NPI assigned
Sep 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 4500 FL Primary

Addresses

Primary practice location

1028 E Osceola Pkwy
Kissimmee, FL 34744-1607

Mailing address

1028 E Osceola Pkwy
Kissimmee, FL 34744-1607
Phone (407) 483-5906

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drlopez@magrudereye.imwdirect.com Direct

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141010001250 FL Practitioner - Optometry 5294974424 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4500FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Avenue Ophthalmics, PLLC Optometrist CurrentSince Jan 1, 2020 Accepting new patients
Osceola Optical & Eye Care Optometrist CurrentSince Feb 11, 2011 Accepting new patients
Park Avenue Ophthalmics, PLLC Optometrist CurrentSince Jan 1, 2020 Accepting new patients
Magruder Eye Institute, PLLC CurrentSince Mar 1, 2019 Accepting new patients

Locations

2269 E Semoran Blvd
Apopka, FL 32703
Phone (407) 886-2093

1028 E Osceola Pkwy
Kissimmee, FL 34744
Phone (407) 483-5906

2065 E Osceola Pkwy
Kissimmee, FL 34743
Phone (407) 344-3603

1911 N Mills Ave
Orlando, FL 32803
Phone (407) 893-8200

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": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1447583950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 E OSCEOLA PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441607",
            "telephone_number": "407-483-5906",
            "fax_number": "407-483-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 E OSCEOLA PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441607",
            "telephone_number": "407-483-5906",
            "fax_number": "407-483-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "VIVIANA",
        "middle_name": "DEL C.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drlopez@magrudereye.imwdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "1028 E Osceola Pkwy",
            "city": "Kissimmee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347441607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.