Individual provider Active NPI

Javier Perez Lopez

  • Family Nurse Practitioner
  • Medley, FL
National Provider Identifier
1689484404
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11037138 Issued in FL
Practice address
7911 NW 72ND Ave Ste 111
Medley, FL 33166-2221
Phone
(305) 888-6959
NPI assigned
Jan 13, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11037138 FL Primary

Addresses

Primary practice location

7911 NW 72ND Ave Ste 111
Medley, FL 33166-2221

Mailing address

4130 NE 22ND St
Homestead, FL 33033-5136
Phone (786) 720-4569

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260205003128 FL Practitioner - Nurse Practitioner 8527547900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1460 S Palm Ave
Pembroke Pines, FL 33025-5520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11037138FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Moya-Prida MD Family CurrentSince Dec 31, 2025 Accepting new patients

Locations

7911 NW 72nd Ave
Ste 111
Medley, FL 33166
Phone (305) 888-6959

1460 S Palm Ave
Pembroke Pines, FL 33025
Phone (305) 888-6959

Organizations & group practices 1

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": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1689484404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 NE 22ND ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330335136",
            "telephone_number": "786-720-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7911 NW 72ND AVE STE 111",
            "city": "MEDLEY",
            "state": "FL",
            "postal_code": "331662221",
            "telephone_number": "305-888-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ LOPEZ",
        "first_name": "JAVIER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-13",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11037138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medley, FL

Sources for this page

Verify at the official NPI Registry.