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General NPI Number Information
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NPI Number | 1972294106
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Entity Type | Individual
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Provider Name | LENNYS LOPEZ ALICEA
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Gender | Female
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Dates
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Enumeration Date | 05/18/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | CALLE HOSTOS ESQUINA CALLE COMERCIO LOCAL 1B
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone | 787-580-7533
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 101 PO BOX 94000
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City | COROZAL
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State | PR
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Zip | 00783
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Country | US
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Telephone | 787-245-7450
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 001477
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License Number State | PR
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