MEDICARE: MISS EDNA M LOPEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	3634	PR

General Provider Information

NPI Number	:	1093715229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS EDNA M LOPEZ

Provider Business Mailing Address
First Line	:	904 CALLE 31 SO
Second Line	:	LAS LOMAS RIO PIEDRAS
City	:	SAN JUAN
State	:	PR
Zip	:	00921-2426
Country	:	US
Telephone Number	:	787-799-2177
Fax Number	:	787-279-0156

Provider Business Practice Location Address
First Line	:	904 CALLE 31 SO
Second Line	:	LAS LOMAS RIO PIEDRAS
City	:	SAN JUAN
State	:	PR
Zip	:	00921-2426
Country	:	US
Telephone Number	:	787-799-2177
Fax Number	:	787-279-0156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	06/19/2025

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Directions to “ MISS EDNA M LOPEZ ” Practice Location

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