Provider Demographics
NPI:1366477515
Name:LOPEZ TORRES, SARA A (DPM)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:LOPEZ TORRES
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 AVE FD ROOSEVELT
Mailing Address - Street 2:OF. 107
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2103
Mailing Address - Country:US
Mailing Address - Phone:787-753-2626
Mailing Address - Fax:
Practice Address - Street 1:400 AVE FD ROOSEVELT
Practice Address - Street 2:OF. 107
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2103
Practice Address - Country:US
Practice Address - Phone:787-753-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0034213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR073017OtherPROVIDER NUMBER
PR9660002OtherPROVIDER NUMBER
PR50542OtherPROVIDER NUMBER
PR9660002OtherPROVIDER NUMBER