Basic Information
| Provider Information | |||||||||
| NPI: | 1457333858 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAVOPA | ||||||||
| FirstName: | LOUIS | ||||||||
| MiddleName: | VINCENT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 841 PRUDENTIAL DR STE 1400 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322078364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043965682 | ||||||||
| FaxNumber: | 9043460864 | ||||||||
| Practice Location | |||||||||
| Address1: | US NAVAL HOSPITAL JACKSONVILLE | ||||||||
| Address2: | 2080 CHILD ST | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322140001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9045427340 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2005 | ||||||||
| LastUpdateDate: | 10/19/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | ME63585 | FL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | ME 63585 | FL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.