Provider Demographics
NPI:1023209384
Name:LOPEZ, JANICE N
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:N
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 5 BOX 25781
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-9846
Mailing Address - Country:US
Mailing Address - Phone:939-475-2466
Mailing Address - Fax:
Practice Address - Street 1:HC 6 BOX 61400
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-9022
Practice Address - Country:US
Practice Address - Phone:787-820-2148
Practice Address - Fax:787-820-8181
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6449183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician