MEDICARE: JOEL R LOPES JR. MD

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	207L00000X	Anesthesiology Physician	320699	NY

General Provider Information

NPI Number	:	1538145891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL R LOPES JR. MD

Provider Business Mailing Address
First Line	:	171 COVETED PL
Second Line	:
City	:	YULEE
State	:	FL
Zip	:	32097-3663
Country	:	US
Telephone Number	:	617-721-7441
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 COVETED PL
Second Line	:
City	:	YULEE
State	:	FL
Zip	:	32097-3663
Country	:	US
Telephone Number	:	617-721-7441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	01/26/2025

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