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General NPI Number Information
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NPI Number | 1578778932
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Entity Type | Individual
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Provider Name | EDWIN LOPEZ I M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | CARR. # 2 B.O. JUAN SANCHEZ
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City | BAYAMON
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State | PR
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Zip | 00959-5139
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Country | US
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Telephone | 787-782-8250
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE SANTA FE D-1 LA INMACULADA
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City | TOA BAJA
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State | PR
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Zip | 00949-3972
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Country | US
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Telephone | 787-780-1006
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Fax | 787-780-1006
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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 | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | 9776
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License Number State | PR
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