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NPI Code Detail

MEDICARE: DR. MAYRA LOPEZ M.D.

MEDICARE: DR. MAYRA LOPEZ M.D.
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
1207R00000XInternal Medicine Physician16817PR
2208D00000XGeneral Practice PhysicianACN469FL

Other Identifiers

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

General Provider Information

NPI Number : 1558568816
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAYRA LOPEZ M.D.
Provider Business Mailing Address
First Line : 8904 W HAMILTON AVE
Second Line :
City : TAMPA
State : FL
Zip : 33615-2726
Country : US
Telephone Number : 813-509-8083
Fax Number :
Provider Business Practice Location Address
First Line : 4618 N ARMENIA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33603-2706
Country : US
Telephone Number : 813-997-6042
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 04/23/2026

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Directions to “ DR. MAYRA LOPEZ M.D.” Practice Location

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