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General NPI Number Information
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NPI Number | 1457303257
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Entity Type | Individual
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Provider Name | MARITZA LOPEZ RODRIGUEZ OD
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Gender | Female
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 03/29/2013
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Provider Practice Location Address
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Address Line | 975 AVE HOSTOS SUITE 62
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City | MAYAGUEZ
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State | PR
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Zip | 00680-1251
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Country | US
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Telephone | 787-832-5540
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Fax | 787-832-5540
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Provider Business Mailing Address
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Address Line | URB LA CONCEPCION ROSARIO ST 133
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City | CABO ROJO
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State | PR
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Zip | 00623
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Country | US
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Telephone | 787-399-7831
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Fax | 787-832-5540
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 358
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License Number State | PR
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