DR. JUAN PABLO LOPEZ GONZALEZ (NPI# 1225210685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225210685 |
| Entity Type | Individual |
| Full Name | DR. JUAN PABLO LOPEZ GONZALEZ |
| Credential | MD |
| Practice Address |
34490 Cortez Blvd Ridge Manor FL 33523-8908 |
| Practice Telephone | 3525834520 |
| Mailing Telephone | 3525834520 |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2020-05-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 16911 | PR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PR | MEDICINE LICENSE | 16911 | 01 |
| Street Address |
34490 CORTEZ BLVD |
| City | RIDGE MANOR |
| State | FL |
| Zip Code | 33523-8908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396275939 | Tejal Shah | Pharmacist | 34490 Cortez Blvd, Ridge Manor, FL 33523-8908 | 2017-06-15 |
| 1922450196 | Ridge Manor Pharmacy | Pharmacy | 34490 Cortez Blvd, Ridge Manor, FL 33523-8908 | 2016-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306446703 | Emad Mansour | Pharmacist | 21650 Us Highway 301, Dade City, FL 33523 | 2020-10-27 |
| 1255738977 | Premier Community Healthcare Group, Inc | Clinic/Center | 38724 Mudcat Grant Blvd, Dade City, FL 33523 | 2014-11-24 |
| 1881869709 | Diana Y Leland | Massage Therapist | 15000 Citrus Country Dr, Suite 212, Dade City, FL 33523 | 2008-04-23 |
| 1659642049 | Spirit Enterprises | Nursing Care | 34213 Spirit Hills Way, Dade City, FL 33523-0630 | 2012-01-18 |
| 1851679088 | Vicky Jane Bahmann | Contractor | 36915 Patton Rd, Dade City, FL 33523-1209 | 2011-07-21 |
| 1265668966 | Carla A Bevins | Speech-Language Pathologist | 21115 Hunter Hill Dr, Dade City, FL 33523-1313 | 2009-06-09 |
| 1023139920 | Kristina May Lombardi | Pharmacist | 30704 Hawkeye Rd, Dade City, FL 33523-1943 | 2007-04-02 |
| 1942491154 | Beth Lorraine Genho | Dentist | 37615 Martin Luther King Blvd, Dade City, FL 33523-3099 | 2007-08-05 |
| 1649882945 | Premier Community Healthcare Group, Inc | Clinic/Center | 37615 Martin Luther King Blvd, Dade City, FL 33523-3099 | 2020-08-18 |
| 1972027654 | Momentum Physical Therapy and Fitness Pllc | Physical Therapist | 14540 7th St, Dade City, FL 33523-3101 | 2017-08-03 |
| Find all providers in zip 33523 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376727040 | Rafael Carlos Crespo | General Practice | 34498 Cortez Blvd, Ridge Manor, FL 33523-8908 | 2007-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033823 | Bless Medical Center of Nmb LLC | General Practice | 1400 Ne Miami Gardens Dr Ste 209, North Miami Beach, FL 33179-4844 | 2020-11-02 |
| 1982203634 | Central Florida Wellness LLC | General Practice | 15516 W Colonial Dr Ste 111, Winter Garden, FL 34787-9558 | 2020-10-23 |
| 1760080212 | Summit Health Multi Specialty of Florida LLC | General Practice | 1881 W Kennedy Blvd Ste D, Tampa, FL 33606-1611 | 2020-10-15 |
| 1376140772 | Amy Wrenn | General Practice | 155 Cranes Roost Blvd Ste 2020-a, Altamonte Springs, FL 32701-3468 | 2020-10-08 |
| 1992302574 | Avita Medical Clinic, LLC | General Practice | 14831 N Florida Ave, Tampa, FL 33613-1825 | 2020-10-06 |
| 1568069672 | Ernesto Oscar Gonzalez Pupo | General Practice | 14420 Sw 22nd St, Miami, FL 33175-6338 | 2020-10-02 |
| 1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
| 1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
| 1902412786 | New Era Medical Pllc | General Practice | 628 Cleveland St Ste A, Clearwater, FL 33755-6603 | 2020-09-17 |
| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | RIDGE MANOR |
| Zip Code | 33523 |
Please comment or provide details below to improve the information on DR. JUAN PABLO LOPEZ GONZALEZ.
| 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.