Ivan Lopezllavore, PTA

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

PTA20203 Issued in FL

Practice address

3011 Sabal Bend Dr NE
Winter Haven, FL 33881-5108

Phone

(863) 651-3040

NPI assigned

Jul 6, 2009

Sex

Male

Sole proprietor

Yes

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.

• Alliance Care LLC

  • Physical Therapy Assistant
  • Winter Haven, FL
  • NPI 1295592228
  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 20, 2024.

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1740419225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 WHISPERING TRAILS AVE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338841826",
            "telephone_number": "863-651-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 SABAL BEND DR NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338815108",
            "telephone_number": "863-651-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZLLAVORE",
        "first_name": "IVAN",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA20203",
            "primary": false
        },
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "FL",
            "license": "NH4843",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "PTA20203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Lopez
• Francis Lopez, BCBA
• Gamal Lopez, APRN, FNP-C
• Heather Lopez
• William Lopez Jr., MD
• Adileni Lora
• Marni Rene Lord, APRN
• Christa Lorgeat, APRN, DNP
• Lou'S Home Care LLC
• Grace Loudaros

• All providers in Winter Haven, FL
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.