Provider Demographics
NPI:1417938689
Name:LOPERA, JOHN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LOPERA
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 1:3325 FOREST HILL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5812
Mailing Address - Country:US
Mailing Address - Phone:561-227-5597
Mailing Address - Fax:561-249-6162
Practice Address - Street 1:3325 FOREST HILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5812
Practice Address - Country:US
Practice Address - Phone:561-227-5597
Practice Address - Fax:561-249-6162
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91277208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271749200Medicaid
FL50338OtherBCBS
P00307191OtherRR MCR
FL271749200Medicaid
FL50338XMedicare PIN
FL50338YMedicare PIN
FL50338AMedicare PIN