Individual provider Active NPI

Gamal Lopez, APRN, FNP-C

  • Family Nurse Practitioner
  • Winter Haven, FL
National Provider Identifier
1912309949
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11046343 Issued in FL
Practice address
2775 Lake Alfred Rd
Winter Haven, FL 33881-1432
Phone
(863) 291-4590
Fax
(863) 508-6503
NPI assigned
Sep 22, 2014
Last updated
Apr 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 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 11046343 FL Primary

Addresses

Primary practice location

2775 Lake Alfred Rd
Winter Haven, FL 33881-1432

Mailing address

81 Lake Ring Dr
Winter Haven, FL 33884-1422
Phone (305) 799-8607

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
I20260624002258 FL Practitioner - Nurse Practitioner 6709359482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12171 SW 268TH St
Homestead, FL 33032-8001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11046343FLMDFamily Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1912309949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 LAKE RING DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338841422",
            "telephone_number": "305-799-8607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 LAKE ALFRED RD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338811432",
            "telephone_number": "863-291-4590",
            "fax_number": "863-508-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "GAMAL",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-22",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11046343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.