MEDICARE: JOSE A LOPEZ M.D P.A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861705725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSE A LOPEZ M.D P.A

Provider Business Mailing Address
First Line	:	30 REMINGTON RD
Second Line	:	SUITE 2
City	:	OAKLAND
State	:	FL
Zip	:	34787-9797
Country	:	US
Telephone Number	:	407-392-1919
Fax Number	:	407-392-1917

Provider Business Practice Location Address
First Line	:	30 REMINGTON RD
Second Line	:	SUITE 2
City	:	OAKLAND
State	:	FL
Zip	:	34787-9797
Country	:	US
Telephone Number	:	407-392-1919
Fax Number	:	407-392-1917

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSE A LOPEZ
Credential	:	M.D
Telephone Number	:	407-392-1919

Provider Enumeration Date	:	07/21/2010
Last Update Date	:	05/15/2025

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