Healthcare Provider Details

I. General information

NPI: 1962734624
Provider Name (Legal Business Name): YANIA M LOPEZ-ALVAREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2010
Last Update Date: 06/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ADMINISTRACION DE SERVICIOS MEDICOS - RADIOLOGIA CENTRO MEDICO DE PR BO MONACILLOS
RIO PIEDRAS PR
00935
US

IV. Provider business mailing address

PO BOX 29134
SAN JUAN PR
00929-0134
US

V. Phone/Fax

Practice location:
  • Phone: 787-777-3535
  • Fax: 787-777-3858
Mailing address:
  • Phone: 787-777-3535
  • Fax: 787-777-3858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number18691
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number18691
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: