MEDICARE: MR. JAVIER ANDRES LOPEZ MONCAYO 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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	A161893	CA
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	ME124126	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1932526514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAVIER ANDRES LOPEZ MONCAYO MD

Provider Business Mailing Address
First Line	:	5537 SHELDON RD STE K
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3167
Country	:	US
Telephone Number	:	813-885-5817
Fax Number	:	813-886-9421

Provider Business Practice Location Address
First Line	:	5537 SHELDON RD STE K
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3167
Country	:	US
Telephone Number	:	813-885-5817
Fax Number	:	813-886-9421

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

Provider Enumeration Date	:	03/21/2014
Last Update Date	:	06/11/2026

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