MR. JORGE ANTONIO LOPEZ (NPI# 1386076594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386076594 |
| Entity Type | Individual |
| Full Name | MR. JORGE ANTONIO LOPEZ |
| Credential | LMHC |
| Practice Address |
2018 Tally Rd Leesburg FL 34748 |
| Mailing Address |
Po Box 491000 Leesburg FL 34749-1000 |
| Practice Telephone | 3523157400 |
| Practice Fax Number | 3523606656 |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2018-11-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH16456 | FL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2018 Tally Rd, Leesburg, FL 34748 | 3523157400 | 3523606656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164069456 | Jorge Alberto Lopez II | Counselor | 2780 Ssw 37th Ave, Coconut Grove, FL 33133 | 2019-12-05 |
| 1861977613 | Jorge E Lopez | Massage Therapist | 21 Connell Ave, Brockton, MA 02302-2541 | 2018-09-27 |
| 1356847859 | Jorge M Lopez | Assistant Behavior Analyst | 11413 Sw 253rd St, Homestead, FL 33032-6036 | 2018-04-03 |
| 1548688393 | Jorge Lopez Jr. | General Acute Care Hospital | 3029 W Coriander Dr, Tucson, AZ 85741-3659 | 2014-03-30 |
| 1548601750 | Jorge I Lopez | Registered Nurse | 3778 Albatross St, San Diego, CA 92103-3925 | 2013-07-16 |
| 1295936219 | Jorge E Lopez | Assisted Living Facility | 550 Sw 69th Ave, Miami, FL 33144-3636 | 2007-05-29 |
| 1528018504 | Jorge Roberto Lopez | Family Medicine | 1168 San Gabriel Blvd, Suite B, Rosemead, CA 91770-4236 | 2006-05-11 |
| 1437750577 | Jorge Eliseo Lopez | Driver | 550 S Vermont Ave, Los Angeles, CA 90020-1912 | 2020-11-04 |
| 1639712862 | Jorge Lopez | Registered Nurse | 4902 W Highway 83, Ste 2, Roma, TX 78584-7858 | 2019-10-21 |
| 1336633320 | Jorge Lopez | Nurse Practitioner | 9122 Nw 171st Ln, Hialeah, FL 33018-6645 | 2018-06-21 |
| Street Address |
2018 TALLY RD |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121941 | Patrick L Smith | Counselor | 117 Dove Ln, Leesburg, GA 31763-6211 | 2020-10-14 |
| 1326645987 | Crossroads Counseling and Empowerment Services LLC | Counselor | 1005 Meadowbend Dr, Leesburg, FL 34748-7237 | 2020-10-07 |
| 1457971723 | Erin H. Davis LLC | Counselor | 42108 Saxon Shore Dr, Leesburg, VA 20176-7621 | 2020-04-16 |
| 1225664535 | Sydney Lambert | Counselor | 212 E Market St Ste 201, Leesburg, VA 20176-3113 | 2020-03-18 |
| 1235772427 | Cheryl Diane Richardson | Counselor | 389 Acorn Ln, Leesburg, FL 34748-7120 | 2019-10-21 |
| 1336700202 | Colleen Copeland Smith | Counselor | 40935 Grenata Preserve Pl, Leesburg, VA 20175-8720 | 2019-06-21 |
| 1811474679 | Tina Marie Deveau | Counselor | 5826 Whisper Pine Dr, Leesburg, FL 34748-1333 | 2018-07-24 |
| 1508357575 | Ronette Key | Counselor | 102 Heritage Way Ne Ste 301, Leesburg, VA 20176-4544 | 2018-05-24 |
| 1982105094 | Janet Erickson Shipley | Counselor | 102 W Dixie Ave, Leesburg, FL 34748-6351 | 2018-02-23 |
| 1699286930 | Calexar LLC | Counselor | 1509 Barksdale Dr Ne, Leesburg, VA 20176-6606 | 2017-10-13 |
| Find all providers in LEESBURG | ||||
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| 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.