Provider Demographics
NPI:1497364160
Name:LOPEZ, CLAUDIA SOFIA (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:SOFIA
Last Name:LOPEZ
Suffix:
Gender:F
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:PALMAS DEL MAR
Mailing Address - Street 2:ARENAS #45
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-6002
Mailing Address - Country:US
Mailing Address - Phone:787-457-1058
Mailing Address - Fax:
Practice Address - Street 1:PALMAS DEL MAR
Practice Address - Street 2:ARENAS #45
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-6002
Practice Address - Country:US
Practice Address - Phone:787-457-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21709208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice