Provider Demographics
NPI:1548592744
Name:LOPEZ BAQUERO, RAFAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:J
Last Name:LOPEZ BAQUERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 370330
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-0330
Mailing Address - Country:US
Mailing Address - Phone:787-767-2248
Mailing Address - Fax:787-766-3219
Practice Address - Street 1:CENTRO MEDICO MENONITA CAYEY
Practice Address - Street 2:EDIF PROFESSIONAL SUITE 307
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-692-9899
Practice Address - Fax:787-766-3219
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR188842084E0001X, 2084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology