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General NPI Number Information
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NPI Number | 1235325846
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Entity Type | Organization
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Legal Business Name | ALBERTO T LOPEZ
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | NATIONAL PLAZA 431 PONCE DE LEON SUITE 900
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City | SAN JUAN
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State | PR
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Zip | 00917
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Country | US
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Telephone | 787-751-2277
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Fax | 787-751-2278
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Provider Business Mailing Address
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Address Line | PO BOX 19707
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City | SAN JUAN
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State | PR
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Zip | 00910-1707
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Country | US
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Telephone | 787-751-2277
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Fax | 787-751-2278
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ALBERTO THOMAS LOPEZ-ENRIQUEZ
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Credential | MD
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Telephone | 787-751-2277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 6707
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License Number State | PR
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