Healthcare Provider Details

I. General information

NPI: 1942246210
Provider Name (Legal Business Name): DAVID LEOPOLDO LOPEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 58TH ST N
CLEARWATER FL
33760-3758
US

IV. Provider business mailing address

14100 58TH ST N STE 100
CLEARWATER FL
33760-9900
US

V. Phone/Fax

Practice location:
  • Phone: 727-824-8181
  • Fax:
Mailing address:
  • Phone: 727-824-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberME76319
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME76319
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: