Provider Demographics
NPI:1407826217
Name:SANCHEZ-LOPEZ, CARMEN DELIA
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:DELIA
Last Name:SANCHEZ-LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 361478
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1478
Mailing Address - Country:US
Mailing Address - Phone:787-756-6515
Mailing Address - Fax:787-783-8378
Practice Address - Street 1:422 CALLE AGUEYBANA
Practice Address - Street 2:EL VEDADO, HATO REY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3351
Practice Address - Country:US
Practice Address - Phone:787-756-6515
Practice Address - Fax:787-783-8378
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6763208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC-797774Medicare ID - Type UnspecifiedMEDICARE