Individual provider Active NPI

Carmen Lissett Lopez, APRN

  • Family Nurse Practitioner
  • Coral Gables, FL
National Provider Identifier
1871955906
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9292584 Issued in FL
Practice address
5555 Ponce de Leon Blvd Ste 128
Coral Gables, FL 33146-2513
Phone
(305) 284-9100
Fax
(305) 284-4098
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9292584 FL
Family Nurse Practitioner 363LF0000X APRN9292584 FL Primary

Addresses

Primary practice location

5555 Ponce de Leon Blvd Ste 128
Coral Gables, FL 33146-2513

Mailing address

5555 Ponce de Leon Blvd Ste 128
Coral Gables, FL 33146-2513
Phone (305) 284-9100

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
I20170316000778 FL Practitioner - Nurse Practitioner 8628353562 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9292584FLMDNurse Practitioner
APRN9292584FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Miami Criticare Inc. Nurse Practitioner CurrentSince Jan 8, 2017 Accepting new patients

Locations

9555 SW 162nd Ave
Miami, FL 33196
Phone (786) 467-2000

6200 SW 73rd St
South Miami, FL 33143
Phone (305) 661-4611

Interoperability endpoints

  • Direct secure messaging: clopez42097@direct.med.miami.edu

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1871955906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PONCE DE LEON BLVD STE 128",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462513",
            "telephone_number": "305-284-9100",
            "fax_number": "305-284-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PONCE DE LEON BLVD STE 128",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462513",
            "telephone_number": "305-284-9100",
            "fax_number": "305-284-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "CARMEN",
        "middle_name": "LISSETT",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9292584",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9292584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.