MEDICARE: JOSE R LOPEZ-REYMINDI MD

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	207X00000X	Orthopaedic Surgery Physician	7611	PR

General Provider Information

NPI Number	:	1174714398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE R LOPEZ-REYMINDI MD

Provider Business Mailing Address
First Line	:	PMB 245 SUITE 112
Second Line	:	100 GRAND BLVD. PASEO
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5625
Country	:	US
Telephone Number	:	787-637-5544
Fax Number	:	787-292-0825

Provider Business Practice Location Address
First Line	:	GALERIA LOS PASEOS
Second Line	:	SUITE 108-A
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5905
Country	:	US
Telephone Number	:	787-637-5544
Fax Number	:	787-292-0825

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

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	08/05/2007

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