Provider Demographics
NPI:1932883774
Name:PROSPERITY FAMILY MEDICAL GROUP
Entity Type:Organization
Organization Name:PROSPERITY FAMILY MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:NARANJO LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-597-3223
Mailing Address - Street 1:225 SONOMA ISLES CIR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-5494
Mailing Address - Country:US
Mailing Address - Phone:786-597-3223
Mailing Address - Fax:561-794-0457
Practice Address - Street 1:11380 PROSPERITY FARMS RD STE 215
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3465
Practice Address - Country:US
Practice Address - Phone:561-794-0456
Practice Address - Fax:561-794-0457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty