Healthcare Provider Details

I. General information

NPI: 1245253178
Provider Name (Legal Business Name): JOSEFINA M. LOPEZ-GARCIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 CALLE AUSTRAL ALTAMIRA
SAN JUAN PR
00920-4239
US

IV. Provider business mailing address

618 CALLE AUSTRAL ALTAMIRA
SAN JUAN PR
00920-4239
US

V. Phone/Fax

Practice location:
  • Phone: 787-409-5828
  • Fax: 787-999-1723
Mailing address:
  • Phone: 787-409-5828
  • Fax: 787-999-1723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7561
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: