Provider Demographics
NPI:1558336552
Name:APONTE LOPEZ, JAIME R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:R
Last Name:APONTE LOPEZ
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 1331
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-1331
Mailing Address - Country:US
Mailing Address - Phone:787-851-5419
Mailing Address - Fax:787-851-5419
Practice Address - Street 1:74 CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-1331
Practice Address - Country:US
Practice Address - Phone:787-851-5419
Practice Address - Fax:787-851-5419
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10986174400000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF50085Medicare UPIN
PR83246Medicare ID - Type Unspecified