Provider Demographics
NPI:1609101898
Name:TOPCARE MD MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:TOPCARE MD MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOPEZ-GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-939-2200
Mailing Address - Street 1:8911 DANIELS PKWY STE 7
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-0872
Mailing Address - Country:US
Mailing Address - Phone:239-939-2200
Mailing Address - Fax:239-939-2204
Practice Address - Street 1:8911 DANIELS PKWY STE 7
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-0872
Practice Address - Country:US
Practice Address - Phone:239-939-2200
Practice Address - Fax:239-939-2204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92874261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI41954Medicare UPIN