Organization Active NPI

Giovanni Lupo, Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Melbourne, FL
National Provider Identifier
1497158125
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME76857 Issued in FL
Legal business name
GIOVANNI LUPO, INC
Practice address
1032 Fieldstone Dr
Melbourne, FL 32940-1633
Phone
(321) 435-3500
Fax
(321) 752-4489
NPI assigned
Oct 8, 2014
Last updated
Oct 8, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Authorized official

Name
Giovanni Lupo, MDNPI 1255394060
Title
Owner
Phone
(321) 259-6478

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
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME76857 FL Primary

Addresses

Primary practice location

1032 Fieldstone Dr
Melbourne, FL 32940-1633

Mailing address

1032 Fieldstone Dr
Melbourne, FL 32940-1633
Phone (321) 435-3500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150108001408 FL Part B Supplier - Clinic/Group Practice 7113240672 Receives reassigned benefits from 1 practitioner
Practice locations: Viera, FL; West Melbourne, FL; Rockledge, FL; Palm Bay, FL; Melbourne, FL

National Provider Directory

National Provider Directory

Locations

1420 Oak St
#102
Melbourne, FL 32901
Phone (321) 723-3215

1765 W Hibiscus Blvd
Melbourne, FL 32901
Phone (321) 733-7111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1497158125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 FIELDSTONE DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401633",
            "telephone_number": "321-435-3500",
            "fax_number": "321-752-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 FIELDSTONE DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401633",
            "telephone_number": "321-435-3500",
            "fax_number": "321-752-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIOVANNI LUPO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "LUPO",
        "authorized_official_first_name": "GIOVANNI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-259-6478",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME76857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.