Individual provider Active NPI

Salvador Lopez, ATC, LAT

  • Athletic Trainer
  • Tampa, FL
National Provider Identifier
1902211691
Registry record updated Jun 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL 3624 Issued in FL
Practice address
4202 E Fowler Ave
Ath 100
Tampa, FL 33620-8000
Phone
(813) 974-0669
NPI assigned
Jun 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL 3624 FL Primary

Addresses

Primary practice location

4202 E Fowler Ave
Ath 100
Tampa, FL 33620-8000

Mailing address

4202 E Fowler Ave
Ath 100
Tampa, FL 33620-8000
Phone (813) 974-0669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AL 3624FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1403395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403395200000",
    "number": "1902211691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 E FOWLER AVE",
            "address_2": "ATH 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336208000",
            "telephone_number": "813-974-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 E FOWLER AVE",
            "address_2": "ATH 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336208000",
            "telephone_number": "813-974-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "SALVADOR",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-22",
        "last_updated": "2014-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL 3624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2014; 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.