Healthcare Provider Details

I. General information

NPI: 1003710021
Provider Name (Legal Business Name): CARMEN MARIA LOPEZ BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 3 BOX 9792
LARES PR
00669-9566
US

IV. Provider business mailing address

HC 3 BOX 9792
LARES PR
00669-9566
US

V. Phone/Fax

Practice location:
  • Phone: 787-246-9316
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0099497
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number0099497
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number0099497
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number0099497
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: