MEDICARE: ADRIAN 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	208100000X	Physical Medicine & Rehabilitation Physician	PTA.0014841	CO

General Provider Information

NPI Number	:	1669321105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIAN LOPEZ

Provider Business Mailing Address
First Line	:	1209 PASEO DEL NORTE
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81008-2083
Country	:	US
Telephone Number	:	719-569-5691
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 PASEO DEL NORTE
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81008-2083
Country	:	US
Telephone Number	:	719-569-5691
Fax Number	:

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

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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Directions to “ ADRIAN LOPEZ ” Practice Location

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