Provider Demographics
NPI:1265496970
Name:LOPEZ DEL POZO, JORGE J (MD)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:J
Last Name:LOPEZ DEL POZO
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 1:8169 CALLE CONCORDIA
Mailing Address - Street 2:STE 312 CONDOMINO SAN VICENTE
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1563
Mailing Address - Country:US
Mailing Address - Phone:787-841-2777
Mailing Address - Fax:787-848-0007
Practice Address - Street 1:COND SAN VICENTE
Practice Address - Street 2:SUITE 312
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-866-1212
Practice Address - Fax:787-866-3322
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8331207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0081480EOtherMEDICARE PRHC
0081479DOtherMEDICARE SHCG
E50971Medicare UPIN
0081480EOtherMEDICARE PRHC