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General NPI Number Information
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NPI Number | 1023093176
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Entity Type | Individual
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Provider Name | MRS. GUADALUPE G LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 03/14/2013
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Provider Practice Location Address
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Address Line | AVE 65 INFANTERIA K-M 3.4 BARRIO SABANA LLANA
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City | SAN JUAN
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State | PR
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Zip | 00924
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Country | US
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Telephone | 787-769-7676
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Fax | 787-281-0194
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Provider Business Mailing Address
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Address Line | CALLE 46 SE 1187 REPARTO METROPOLITONO RIO DIERES
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City | SAN JUAN
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State | PR
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Zip | 00921
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Country | US
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Telephone | 787-767-7676
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Fax | 787-281-0194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 025987
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License Number State | PR
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