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General NPI Number Information
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NPI Number | 1972917243
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Entity Type | Individual
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Provider Name | ROMINA LOPEZ RODRIGUEZ MD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 256 CALLE FORTALEZA
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City | SAN JUAN
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State | PR
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Zip | 00901-1713
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Country | US
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Telephone | 787-724-2476
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Fax |
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Provider Business Mailing Address
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Address Line | 6 JOFFRE ST. APT.3-A
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City | SAN JUAN
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State | PR
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Zip | 00907
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 19985
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License Number State | PR
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