Provider Demographics
NPI:1598902017
Name:LOPEZ-CHEVRES, JOSE ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ALBERTO
Last Name:LOPEZ-CHEVRES
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 616788
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6788
Mailing Address - Country:US
Mailing Address - Phone:407-533-6836
Mailing Address - Fax:407-770-0661
Practice Address - Street 1:2577 SIMPSON RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4642
Practice Address - Country:US
Practice Address - Phone:407-348-8338
Practice Address - Fax:407-348-1709
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17410208D00000X
FLACN465208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLACN465OtherME LICENSE
FL008422400Medicaid
FL008422400Medicaid
FL008422400Medicaid