SOMA MEDICAL CENTER, P. A #4 (NPI# 1184920613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184920613 |
| Entity Type | Organization |
| Organization Name | SOMA MEDICAL CENTER, P. A #4 |
| Practice Address |
421 S Dixie Hwy Lake Worth FL 33460-4442 |
| Practice Telephone | 5612751155 |
| Practice Fax Number | 5612751156 |
| Mailing Telephone | 5612751155 |
| Mailing Fax Number | 5612751156 |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2019-12-11 |
| Authorized Official Name | DR. MERCEDES GADEA LOPEZ (PEDIATRICIAN) |
| Authorized Official Telephone | 5612751155 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | SOMA MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | ME102127 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 005584600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942770912 | Soma Medical Center, P. A #4 | Pediatrics | 10125 W Colonial Dr Ste 204, Ocoee, FL 34761-4200 | 2018-12-03 |
| Street Address |
421 S DIXIE HWY |
| City | LAKE WORTH |
| State | FL |
| Zip Code | 33460-4442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255971677 | Kaitlan Andrea Castillo | Nurse Practitioner | 421 S Dixie Hwy, Lake Worth, FL 33460-4442 | 2020-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265069694 | Soma Medical Center, P.a. | Internal Medicine | 330 South Dixie Hway, Lake Worth, FL 33460 | 2020-03-25 |
| 1659920072 | Dr G's Pharmacy, Inc | Pharmacy | 127 N Dixie Highway, Lake Worth, FL 33460 | 2019-09-09 |
| 1710542428 | Paul Robert Ahr | Psychologist | 702 N. Lakeside Drive, Lake Worth Beach, FL 33460 | 2019-05-08 |
| 1548732985 | Pickens Allison Gantt IIi | Acupuncturist | 1505 N Federal Hwy, Lake Worth, FL 33460 | 2018-12-26 |
| 1992297634 | Awilda Theodore | Homemaker | 824a Lake Ave, #309, Lake Worth, FL 33460 | 2018-05-30 |
| 1326562646 | Candy Marie Contrerez | Behavior Technician | 1306 S H St, Lake Worth, FL 33460 | 2017-07-28 |
| 1679003602 | Sylvia Grant | Registered Nurse | 919 12th Ave S, Lake Worth, FL 33460 | 2017-06-13 |
| 1720510662 | Jessica Montanez | Technician, Other | 1831 17th Court N, Lake Worth, FL 33460 | 2017-03-30 |
| 1629209630 | Emilia Isaza | Dentist | 325 S. Dixie Hwy, Suite #5, Lake Worth, FL 33460 | 2009-08-07 |
| 1174767909 | Cameron Bishop | Acupuncturist | 1505 North Federal Highway, Lake Worth, FL 33460 | 2009-04-23 |
| Find all providers in zip 33460 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235528035 | Jacqueline Guillaume | Pediatrics | 9595 Caserta St, Lake Worth, FL 33467-5220 | 2015-01-16 |
| 1750693867 | Mercedes Gadea Lopez | Pediatrics | 330 S Dixie Hwy, Suite #3, Lake Worth, FL 33460-4400 | 2010-07-06 |
| 1063566438 | Edelstein Pediatrics | Pediatrics | 5820 Jog Rd, Lake Worth, FL 33467-6511 | 2007-01-23 |
| 1063594190 | Wayne W Yee | Pediatrics | 3900 Boat Club Rd, Lake Worth, TX 76135-3201 | 2006-10-19 |
| 1538253604 | Lawrence Lutner | Pediatrics | 10902 Royal Devon Way, Lake Worth, FL 33467-8652 | 2006-10-03 |
| 1699783183 | Dhruti Pandya | Pediatrics | 4075 S State Road 7 Ste H1, Lake Worth, FL 33449-8152 | 2006-08-03 |
| 1780637975 | Zulma Enid Flores | Pediatrics | 3580 Lake Worth Road, Lake Worth, FL 33460 | 2006-05-18 |
| 1629056536 | Lee Wichner Edelstein | Pediatrics | 6045 Hagen Ranch Rd Ste 4, Lake Worth, FL 33467-7251 | 2006-01-03 |
| 1134118797 | Lisa Simons | Pediatrics | 4075 State Road 7, H1, Lake Worth, FL 33449-8186 | 2005-10-17 |
| 1578564829 | Jason Paul Stein | Pediatrics | 6169 Jog Rd, Ste 82, Lake Worth, FL 33467-6579 | 2005-08-09 |
| Find all providers in LAKE WORTH | ||||
| City | LAKE WORTH |
| Zip Code | 33460 |
Please comment or provide details below to improve the information on SOMA MEDICAL CENTER, P. A #4.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.