Provider Demographics
NPI:1336033950
Name:LOPEZ CARDONA, HECTOR (MD)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:LOPEZ CARDONA
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 1:324 HADRIAN ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4705
Mailing Address - Country:US
Mailing Address - Phone:610-202-5091
Mailing Address - Fax:
Practice Address - Street 1:390 STUDENT CENTER CIRCLE 2500 MEISLER HALL
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36688-0001
Practice Address - Country:US
Practice Address - Phone:610-202-5091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL390200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program