Healthcare Provider Details

I. General information

NPI: 1679427561
Provider Name (Legal Business Name): ROXANA LOPEZ MATIAS ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR NUMERO 2 KM 122, AGUADILLA, 00603
AGUADILLA PR
00603
US

IV. Provider business mailing address

PO BOX 760
AGUADA PR
00602-0760
US

V. Phone/Fax

Practice location:
  • Phone: 939-287-8292
  • Fax:
Mailing address:
  • Phone: 787-375-9896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number123
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: