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General NPI Number Information
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NPI Number | 1104818509
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Entity Type | Individual
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Provider Name | ELBA LOPEZ RPT
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Gender | Female
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7353 AVE RAMOS CALERO A
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City | ISABELA
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State | PR
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Zip | 00662-3500
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Country | US
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Telephone | 787-872-0415
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Fax | 787-872-0415
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Provider Business Mailing Address
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Address Line | 302 CALLE DR HERNANDEZ DEL VALLE
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City | ISABELA
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State | PR
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Zip | 00662-3919
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Country | US
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Telephone | 787-872-0415
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Fax | 787-872-0415
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 739
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License Number State | PR
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