Provider Demographics
NPI:1043208002
Name:NATALI-LOPEZ, ABEL (MD)
Entity Type:Individual
Prefix:MR
First Name:ABEL
Middle Name:
Last Name:NATALI-LOPEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 919771
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-9771
Mailing Address - Country:US
Mailing Address - Phone:239-278-3600
Mailing Address - Fax:239-226-4650
Practice Address - Street 1:3415 LEE BLVD
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1576
Practice Address - Country:US
Practice Address - Phone:239-738-7324
Practice Address - Fax:239-369-6419
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36788207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378708700Medicaid
FLNF435OtherMEDICARE
FL11119OtherBCBS
FL378708700Medicaid
FL11119PMedicare PIN
FL930128336Medicare PIN
FLP00605431OtherRR MEDICARE
FL11119YMedicare PIN