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General NPI Number Information
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NPI Number | 1568657930
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Entity Type | Individual
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Provider Name | PAULETTE C. PACHECO-LOPEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 3950 CARR 176 GARDEN VALLEY CLUB APT 108
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City | SAN JUAN
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State | PR
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Zip | 00926-6737
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Country | US
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Telephone | 787-671-1382
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Fax |
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Provider Business Mailing Address
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Address Line | 3950 CARR 176 GARDEN VALLEY CLUB APT 108
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City | SAN JUAN
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State | PR
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Zip | 00926-6737
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Country | US
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Telephone | 787-671-1382
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 18856
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | D0075253
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License Number State | MD
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