MEDICARE: OSCAR EMILIO RODRIGUEZ LOPEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080H0002X	Pediatric Hospice and Palliative Medicine Physician	4810	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4810	OTHER	PR	STATE PRACTICE LICENSE

General Provider Information

NPI Number	:	1548487234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSCAR EMILIO RODRIGUEZ LOPEZ M.D.

Provider Business Mailing Address
First Line	:	GENOVA STREET, G-31
Second Line	:	EXTENSION VILLA CAPARRA
City	:	GUAYNABO
State	:	PR
Zip	:	00966-1730
Country	:	US
Telephone Number	:	787-630-1525
Fax Number	:	787-793-1913

Provider Business Practice Location Address
First Line	:	GENOVA STREET, G-31
Second Line	:	EXTENSION VILLA CAPARRA
City	:	GUAYNABO
State	:	PR
Zip	:	00966-1730
Country	:	US
Telephone Number	:	787-630-1525
Fax Number	:	787-793-1913

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	09/28/2012

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Directions to “ OSCAR EMILIO RODRIGUEZ LOPEZ M.D.” Practice Location

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