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NPI Code Detail

MEDICARE: DR. HECTOR LUIS LOPEZ-ORTIZ M.D.

MEDICARE: DR. HECTOR LUIS LOPEZ-ORTIZ M.D.
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
1208D00000XGeneral Practice Physician15129PR
2208D00000XGeneral Practice PhysicianACN 200FL

General Provider Information

NPI Number : 1386842342
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HECTOR LUIS LOPEZ-ORTIZ M.D.
Provider Business Mailing Address
First Line : 1092 HAMPSTEAD PL
Second Line :
City : MARTINEZ
State : GA
Zip : 30907-6200
Country : US
Telephone Number : 787-557-6225
Fax Number :
Provider Business Practice Location Address
First Line : 501 GARY HILL RD
Second Line :
City : EDGEFIELD
State : SC
Zip : 29824-4503
Country : US
Telephone Number : 803-637-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2007
Last Update Date : 07/10/2007

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