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General NPI Number Information
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NPI Number | 1881412831
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Entity Type | Individual
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Provider Name | LUIS GEOVANNY GALBAN LOPEZ MD
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Gender | Male
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | BO HATO ABAJO KM 81.0 CARR #2
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City | ARECIBO
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State | PR
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Zip | 00612
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Country | US
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Telephone | 787-896-1850
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Fax |
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Provider Business Mailing Address
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Address Line | URB VISTA AZUL T21 CALLE #25
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City | ARECIBO
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State | PR
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Zip | 00612
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Country | US
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Telephone | 787-236-1070
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2249
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License Number State | PR
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