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General NPI Number Information
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NPI Number | 1487796553
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Entity Type | Individual
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Provider Name | ANTONIO MEDINA LOPEZ MD
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | CALLE LOPE HORMAZABAL # 40 URB MADRID
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City | JUNCOS
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State | PR
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Zip | 00777-0000
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Country | US
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Telephone | 787-734-6020
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Fax | 787-737-0006
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Provider Business Mailing Address
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Address Line | 40 CALLE LOPEZ HORMAZABAL
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City | JUNCOS
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State | PR
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Zip | 00777-3105
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Country | US
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Telephone | 787-734-6020
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Fax | 787-734-0006
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 13083
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License Number State | PR
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