Healthcare Provider Details

I. General information

NPI: 1255251492
Provider Name (Legal Business Name): JANCY L LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AA20 CALLE 51
BAYAMON PR
00957-4235
US

IV. Provider business mailing address

AA20 CALLE 51
BAYAMON PR
00957-4235
US

V. Phone/Fax

Practice location:
  • Phone: 787-454-0151
  • Fax:
Mailing address:
  • Phone: 787-454-0151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: