Individual provider Active NPI

Jonathan Lopez

  • Student in an Organized Health Care Education/Training Program
  • Gainesville, FL
National Provider Identifier
1790313062
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1600 SW Archer Rd Ste 4102
Gainesville, FL 32610-3003
Phone
(352) 265-0239
Fax
(352) 265-1107
NPI assigned
Mar 31, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1600 SW Archer Rd Ste 4102
Gainesville, FL 32610-3003

Mailing address

PO Box 100265
Gainesville, FL 32610-0265
Phone (352) 265-0239

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201023000284 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4587084918

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: jlopez459619@direct.shands.ufl.edu

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1790313062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100265",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100265",
            "telephone_number": "352-265-0239",
            "fax_number": "352-265-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD STE 4102",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-0239",
            "fax_number": "352-265-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.