Healthcare Provider Details

I. General information

NPI: 1295656163
Provider Name (Legal Business Name): MISS VALERIE LYNN LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42369 CALLE ARCA DE NOE
QUEBRADILLAS PR
00678-9495
US

IV. Provider business mailing address

PO BOX 4050, ARECIBO PUERTO RICO 00614-4050
ARECIBO PR
00614-4050
US

V. Phone/Fax

Practice location:
  • Phone: 787-487-1750
  • Fax:
Mailing address:
  • Phone: 787-878-5475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number9586195
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: