Healthcare Provider Details

I. General information

NPI: 1093048993
Provider Name (Legal Business Name): DIANY Y. LOPEZ TORRES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 04/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 901 KM1.6 BO JUAN MARTIN
YABUCOA PR
00767
US

IV. Provider business mailing address

CALLE GRANADA NUM 629 LA PALMITA
YAUCO PR
00698
US

V. Phone/Fax

Practice location:
  • Phone: 787-739-8182
  • Fax:
Mailing address:
  • Phone: 787-510-4313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number27632R
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20001
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: