Provider Demographics
NPI:1043511322
Name:LOPEZ-QUILES, LUIS A (LPN)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:A
Last Name:LOPEZ-QUILES
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 STREET BO. BAYANEY
Mailing Address - Street 2:HC-07 BOX32606
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659
Mailing Address - Country:US
Mailing Address - Phone:787-308-6563
Mailing Address - Fax:
Practice Address - Street 1:129 STREET ANTIGUO HOSPITAL DE DISTRITO
Practice Address - Street 2:COTTO STATION BOX 9550
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-878-3552
Practice Address - Fax:787-879-8633
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21911164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse