Healthcare Provider Details

I. General information

NPI: 1700896388
Provider Name (Legal Business Name): ARTURO CORDOVA LOPEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. CASA LINDA NUM. 1 SUITE 101 ENTRADA AMERICAN MILITARY ACADEMY
BAYAMON PR
00959
US

IV. Provider business mailing address

PO BOX 10068
SAN JUAN PR
00922-0068
US

V. Phone/Fax

Practice location:
  • Phone: 787-789-1919
  • Fax: 787-789-1921
Mailing address:
  • Phone: 787-789-1919
  • Fax: 787-789-1921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number5502
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: