Tech Medical Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

TECH MEDICAL CENTER, LLC

Doing business as

Ela Doc Tree

Practice address

416 E 3Rd Ave
Cordele, GA 31015-3605

Phone

(813) 724-3204

Fax

(585) 433-5039

NPI assigned

Feb 9, 2017

Last updated

Feb 9, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

TECH MEDICAL CENTER, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Jose Miguel Lopez, M.D.NPI 1427150846

Title

Owner/Medical Director

Phone

(646) 462-9251

Specialties & licenses 1

Addresses

Other names 1

• Ela Doc Tree Doing business as

Part of

Ela Doc Tree

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Tech Medical Center, LLC

  dba Ela Doc Tree

  • Clinic/Center
  • Waycross, GA
  • NPI 1992252720
  NPPES parent name

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.

• Jose Miguel Lopez, M.D.

  • Internal Medicine Physician
  • Denville, NJ
  • NPI 1427150846
  NPD Authorized official

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1669910675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E 3RD AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153605",
            "telephone_number": "813-724-3204",
            "fax_number": "585-433-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E 3RD AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153605",
            "telephone_number": "813-724-3204",
            "fax_number": "585-433-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TECH MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TECH MEDICAL CENTER, LLC",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "MIGUEL",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "646-462-9251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ela Doc Tree",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Cordele, GA
• Providers in Cordele, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.