Provider Demographics
NPI:1235325846
Name:ALBERTO T LOPEZ
Entity Type:Organization
Organization Name:ALBERTO T LOPEZ
Other - Org Name:QUIMIOTERAPIA AMBULATORIA DR. ALBERTO LOPEZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:LOPEZ-ENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-751-2277
Mailing Address - Street 1:PO BOX 19707
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-1707
Mailing Address - Country:US
Mailing Address - Phone:787-751-2277
Mailing Address - Fax:787-751-2278
Practice Address - Street 1:NATIONAL PLAZA 431 PONCE DE LEON
Practice Address - Street 2:SUITE 900
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-751-2277
Practice Address - Fax:787-751-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6707261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center