Provider Demographics
NPI:1558428649
Name:LOPEZ-MORALES, NAYDA T (MD)
Entity Type:Individual
Prefix:DR
First Name:NAYDA
Middle Name:T
Last Name:LOPEZ-MORALES
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:B-4, POPPY ST.
Mailing Address - Street 2:PARQUE FORESTAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-708-2327
Mailing Address - Fax:
Practice Address - Street 1:B4, POPPY ST.
Practice Address - Street 2:PARQUE FORESTAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-708-2327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9533208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9533OtherSTATE LICENSE