Individual provider Active NPI

Deborah Maria Lopez, MD

  • Pediatric Critical Care Medicine Physician
  • Naples, FL
National Provider Identifier
1922166974
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME 97675 Issued in FL
Practice address
11190 Health Park Blvd
Naples, FL 34110
Phone
(239) 552-7555
NPI assigned
Dec 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X ME 97675 FL Primary
Pediatric Critical Care Medicine Physician 2080P0203X 198763 NY

Addresses

Primary practice location

11190 Health Park Blvd
Naples, FL 34110

Mailing address

6070 Spanish Oaks LN
Naples, FL 34119
Phone (239) 593-5410

Other identifiers 2

IdentifierTypeStateIssuer
97675OtherFLMEDICAL LICENSE
01745399MedicaidNY

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
I20151008001188 FL Practitioner - Pediatric Medicine 1658301577 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 97675FLMDPediatric Critical Care Medicine Physician
198763NYMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Mar 21, 2016 Accepting new patients
Halifax Healthcare Systems Inc CurrentSince Aug 3, 2015 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Mar 21, 2016 Accepting new patients
Flushing Hospital & Medical Center Past Accepting new patients
The Brookdale Hospital Medical Center Past Accepting new patients
Flushing Emergency Practice Plan Past Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

303 N Clyde Morris Blvd
Fl 10
Daytona Beach, FL 32114
Phone (386) 425-2360

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

Organizations & group practices 6

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922166974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6070 SPANISH OAKS LN",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34119",
            "telephone_number": "239-593-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11190 HEALTH PARK BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34110",
            "telephone_number": "239-552-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "DEBORAH",
        "middle_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME 97675",
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NY",
            "license": "198763",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "97675",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01745399",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.