Healthcare Provider Details

I. General information

NPI: 1326497827
Provider Name (Legal Business Name): PEDRO ADROVER LOPEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N US HIGHWAY 441 STE 1106
LADY LAKE FL
32159-6800
US

IV. Provider business mailing address

1501 N US HIGHWAY 441 STE 1106
LADY LAKE FL
32159-6800
US

V. Phone/Fax

Practice location:
  • Phone: 352-504-3500
  • Fax: 352-504-3388
Mailing address:
  • Phone: 352-504-3500
  • Fax: 352-504-3388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number21413
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME155262
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME155262
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: