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General NPI Number Information
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NPI Number | 1073931903
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Entity Type | Individual
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Provider Name | JOVANNA BERTRAN-LOPEZ MD MPH
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Gender | Female
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Dates
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Enumeration Date | 03/28/2014
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | AVE. PONCE DE LEON, PARADA 37.5
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City | SAN JUAN
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State | PR
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Zip | 00919-1227
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Country | US
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Telephone | 787-758-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1353 AVE. LUIS VIGOREAUX, PMB 332
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-225-0411
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Fax |
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME141547
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 19323
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License Number State | PR
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