Healthcare Provider Details

I. General information

NPI: 1497666135
Provider Name (Legal Business Name): PATRICIA NICOLE LOPEZ GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65TH INFANTRY SH. CTR 00253-5
SAN JUAN PR
00925-3215
US

IV. Provider business mailing address

631 CALLE PEREIRA LEAL APT 403
SAN JUAN PR
00923-1932
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-1736
  • Fax:
Mailing address:
  • Phone: 939-318-9535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number17222
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: