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NPI Code Detail

MEDICARE: VICTOR EMILIO VIDAL LOPEZ

MEDICARE: VICTOR EMILIO VIDAL 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1386572865
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTOR EMILIO VIDAL LOPEZ
Provider Business Mailing Address
First Line : URB. MIRADOR DE PARQUE ESCORIAL #25 CALLE CIELO
Second Line :
City : CAROLINA
State : PR
Zip : 00987-5382
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10 CALLE CASIA
Second Line :
City : SAN JUAN
State : PR
Zip : 00921-3201
Country : US
Telephone Number : 787-641-7582
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2026
Last Update Date : 05/13/2026

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Directions to “ VICTOR EMILIO VIDAL LOPEZ ” Practice Location

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