Ivonne Ileana Jacomino Lopez, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11009290 Issued in FL

Practice address

4661 W 8TH LN
Hialeah, FL 33012-3517

Phone

(786) 728-0785

NPI assigned

Oct 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1972102192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4661 W 8TH LN",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123517",
            "telephone_number": "786-728-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4661 W 8TH LN",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123517",
            "telephone_number": "786-728-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOMINO LOPEZ",
        "first_name": "IVONNE",
        "middle_name": "ILEANA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9342058",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11009290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jac Medical Center, Inc
• Anu Sherry Jacob, ARNP
• Yaidelys Jacomino Bermudez
• Jennifer Jacomino
• Jacquis Palace
• Ghulam Jafferi, MD
• Jag Medical Center LLC
• Jaime a. Soteras MD PA

• Family Nurse Practitioner in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.