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General NPI Number Information
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NPI Number | 1770511131
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Entity Type | Individual
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Provider Name | ROBERTO LOPEZ-NIEVES MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | CARR.189 RAMAL 933 INTERIOR 0.9 BARRIO MAMEY LL
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City | GURABO
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State | PR
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Zip | 00778-8824
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Country | US
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Telephone | 787-354-2452
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Fax |
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Provider Business Mailing Address
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Address Line | HC-4 BOX 18698
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City | GURABO
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State | PR
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Zip | 00778-8824
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Country | US
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Telephone | 787-354-2452
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 9513
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License Number State | PR
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