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General NPI Number Information
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NPI Number | 1568345031
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Entity Type | Individual
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Provider Name | CRISTIAN JOSE OLEAGA LOPEZ PA
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Gender | Male
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | PR-984 # 163 BARRIO NARANJO
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City | FAJARDO
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State | PR
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Zip | 00738-2710
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Country | US
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Telephone | 787-988-5965
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Fax |
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Provider Business Mailing Address
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Address Line | HC 66 BOX 7238
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City | FAJARDO
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State | PR
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Zip | 00738-9269
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Country | US
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Telephone | 787-988-5965
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2614
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License Number State | PR
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