Provider Demographics
NPI:1437282977
Name:NAZARIO-LOPEZ, HECTOR ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:ANTONIO
Last Name:NAZARIO-LOPEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HECTOR
Other - Middle Name:ANTONIO
Other - Last Name:NAZARIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1017
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-1017
Mailing Address - Country:US
Mailing Address - Phone:787-833-6806
Mailing Address - Fax:
Practice Address - Street 1:13 CALLE MATTEI LLUBERAS
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3640
Practice Address - Country:US
Practice Address - Phone:787-856-3380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6340207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0027982Medicare ID - Type Unspecified
PRD-95183Medicare UPIN