MEDICARE: DR. RODNEY LOPEZ LOPEZ MD

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	208D00000X	General Practice Physician	14539	PR

General Provider Information

NPI Number	:	1578569216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODNEY LOPEZ LOPEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 686
Second Line	:
City	:	COAMO
State	:	PR
Zip	:	00769
Country	:	US
Telephone Number	:	787-347-5311
Fax Number	:

Provider Business Practice Location Address
First Line	:	CALLE JOSE C VAZQUEZ 2
Second Line	:
City	:	AIBONITO
State	:	PR
Zip	:	00705
Country	:	US
Telephone Number	:	787-735-8001
Fax Number	:

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	09/25/2019

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