Individual
JASON O LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 ROCKY MOUNTAIN AVE STE 100, LOVELAND, CO 80538-9004
(970) 624-1800
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
(813) 974-0483
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
024865
NY
363A00000X
Physician Assistant
Primary
PA.0009136
CO
363A00000X
Physician Assistant
PA9117464
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024865
NYS EDUCATION DEPTARMENT OFFICE OF PROFESSIONS
NY
01
—
1171308
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANT (NCCPA)
—
05
—
119492900
—
FL
01
—
9IGTX
BCBS
FL
Enumeration date
03/19/2020
Last updated
07/21/2025
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