Lopez Family Primary Care Inc | |
6821 Southpoint Dr N Ste 107 Jacksonville FL 32216-8026 | |
(904) 862-6070 | |
(904) 595-3767 |
Full Name | Lopez Family Primary Care Inc |
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Speciality | Family Medicine |
Location | 6821 Southpoint Dr N Ste 107, Jacksonville, Florida |
Authorized Official Name and Position | Diorgi Lopez Suri (OWNER) |
Authorized Official Contact | 9048626070 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lopez Family Primary Care Inc 6821 Southpoint Dr N Ste 107 Jacksonville FL 32216-8026 Ph: (904) 862-6070 | Lopez Family Primary Care Inc 6821 Southpoint Dr N Ste 107 Jacksonville FL 32216-8026 Ph: (904) 862-6070 |
NPI Number | 1922757558 |
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Provider Enumeration Date | 03/21/2022 |
Last Update Date | 03/28/2022 |
Medicare PECOS PAC ID | 8628456381 |
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Medicare Enrollment ID | O20220608001761 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922757558 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
Provider Name | Diorgi Lopez Suri |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841782505 PECOS PAC ID: 3870901804 Enrollment ID: I20210413000094 |
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