Provider Demographics
NPI:1467750018
Name:BIDOT LOPEZ, MONICA (OD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:BIDOT LOPEZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 LOCKHART GDN CTR STE 202
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-2685
Mailing Address - Country:US
Mailing Address - Phone:340-774-8500
Mailing Address - Fax:340-774-3704
Practice Address - Street 1:9000 LOCKHART GDN CTR STE 202
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2685
Practice Address - Country:US
Practice Address - Phone:340-774-8500
Practice Address - Fax:340-774-3704
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI049152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist