Provider Demographics
NPI:1194376921
Name:GARCIA-LOPEZ, MAYLIN AIXA (DC)
Entity Type:Individual
Prefix:
First Name:MAYLIN
Middle Name:AIXA
Last Name:GARCIA-LOPEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 57 BOX 9702
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9715
Mailing Address - Country:US
Mailing Address - Phone:787-427-8313
Mailing Address - Fax:
Practice Address - Street 1:AVE. 21 DE DICIEMBRE #110
Practice Address - Street 2:2NDO NIVEL
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-0063
Practice Address - Country:US
Practice Address - Phone:939-438-5621
Practice Address - Fax:787-873-0586
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor