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General NPI Number Information
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NPI Number | 1891802450
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Entity Type | Individual
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Provider Name | ANTONIO MANUEL OTERO LOPEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 03/19/2013
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Provider Practice Location Address
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Address Line | CLINICA DE LA ESCUELA DE MEDICINA REPARTO METROPOLITANO SHOPPING, AVE. AMERICO MIRANDA
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City | RIO PIEDRAS
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State | PR
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Zip | 00921
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Country | US
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Telephone | 787-764-5095
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Fax |
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Provider Business Mailing Address
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Address Line | ORTOPEDIA RCM PO BOX 29134
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City | SAN JUAN
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State | PR
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Zip | 00929-0134
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Country | US
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Telephone | 787-764-5095
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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 | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 13393
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License Number State | PR
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