JOHANNY LOPEZ DOMINGUEZ MD
NPI 1972187086
Student in an Organized Health Care Education/Training Program in Orlando, FL

Q: What is Johanny Lopez Dominguez's NPI number?

The NPI number for Johanny Lopez Dominguez is 1972187086. It was assigned to this individual provider in the NPPES registry on May 6, 2021.

Q: What is Johanny Lopez Dominguez's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since May 06, 2021PECOS Enrolled

52 W UNDERWOOD ST, ORLANDO, FL 32806(321) 841-5145 Get Directions Write a Review

NPPES record last updated: June 14, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Johanny Lopez Dominguez Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHANNY LOPEZ DOMINGUEZ MD (NPI 1972187086) is an individual student in an organized health care education/training program in Orlando, Florida, licensed in Florida (35293) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS and is a graduate of Mayo Medical School (2022).

NPPES Registry Identity

NPI1972187086

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJOHANNY LOPEZ DOMINGUEZCredential: MD

Location Address52 W UNDERWOOD STOrlando, FL 32806-1110

Mailing Address9745 Touchton Rd Unit 1530Jacksonville, FL 32246-1513

Phone(321) 841-5145

Sole ProprietorNo

Medical School CMSMayo Medical SchoolGraduated 2022

Enumeration DateMay 6, 2021

Last NPPES UpdateJune 14, 2022

NPPES CertifiedJune 14, 2022

✔ NPI 1972187086 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in FL · 35293

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

52 W UNDERWOOD ST, Orlando, FL 32806

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Johanny Lopez Dominguez Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5890175772

PECOS Enrollment IDI20251125001590

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MANDIP KAUR ARNP

Nurse Practitioner (Psychiatric/Mental Health)