Provider Demographics
NPI:1093791626
Name:LOPEZ-TORRES, RAFAEL AUGUSTO (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:AUGUSTO
Last Name:LOPEZ-TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 194000
Mailing Address - Street 2:PMB 285
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-4000
Mailing Address - Country:US
Mailing Address - Phone:787-638-2853
Mailing Address - Fax:
Practice Address - Street 1:BARRIO RINCON, SECTOR LOMAS, CARRETERA 13, KM 12.0
Practice Address - Street 2:ANESTHESIA OFFICE, 3RD FLOOR
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737
Practice Address - Country:US
Practice Address - Phone:787-638-2853
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14165207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21139LOOtherANESTHESIOLOGY
PR2-1139Medicaid
PR2-1139Medicaid
PR2-1139Medicare ID - Type UnspecifiedANESTHESIOLOGY