Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Lidya Margarita Lataban-Lopez, MD

Individual provider General Practice Physician · NPI 1275581829

Dr. Lidya Margarita Lataban-Lopez, MD is a General Practice in Palm Coast, Florida. Qualified in 1990, 36 years ago. Practices with Conviva Medical Center Management, LLC, a 562-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida and Puerto Rico.

Years since qualifying
36
Licensed in
FL, PR
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

20 Cypress Point Pkwy Ste A
Palm Coast, FL 32164-7528
Phone: (386) 586-7005
Fax: (844) 867-3940
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence ACN911 (FL)
General Practice Physician Taxonomy 208D00000X · Licence 15204 (PR)

Record details

NPI number1275581829
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 5, 2006
Last updated in NPPESFebruary 17, 2026
Certification dateFebruary 17, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL PRACTICE
Medical schoolOTHER
Graduated 1990 (36 years in practice)
Group practice Conviva Medical Center Management, Llc — 562 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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