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General NPI Number Information
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NPI Number | 1528970985
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Entity Type | Organization
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Legal Business Name | ASCENCION MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 1048 US HIGHWAY 27 S STE 1050
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City | AVON PARK
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State | FL
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Zip | 33825-5105
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Country | US
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Telephone | 786-353-2573
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Fax |
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Provider Business Mailing Address
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Address Line | 1048 US HIGHWAY 27 S STE 1050
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City | AVON PARK
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State | FL
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Zip | 33825-5105
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | APRN FNP
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Name | GUIDO LOPEZ
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Credential |
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Telephone | 786-353-2573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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