Healthcare Provider Details

I. General information

NPI: 1386719276
Provider Name (Legal Business Name): ZOILO LOPEZ NIEVES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. CAMPO RICO - 7 / CORNER , SABANA GARDEN
CAROLINA PUERTO RICO
00983
UM

IV. Provider business mailing address

PO BOX 1682
CAROLINA PR
00984-1682
US

V. Phone/Fax

Practice location:
  • Phone: 787-768-3373
  • Fax: 787-768-3373
Mailing address:
  • Phone: 787-768-3373
  • Fax: 787-768-3373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5600
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5600
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: