Provider Demographics
NPI:1598212813
Name:DOVAL LOPEZ, AMANDA CRISTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:CRISTINA
Last Name:DOVAL 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:UNIVERSITY DISTRICT HOSPITAL (UDH)
Mailing Address - Street 2:OFFICE A838 ADMINISTRATIVA
Mailing Address - City:SAN JUAN PR
Mailing Address - State:PR
Mailing Address - Zip Code:00936
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:787-751-6034
Practice Address - Street 1:HOSPITAL UPR - FEDERICO TRILLA
Practice Address - Street 2:PRIMER PISO AREA ADMINISTRATIVA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00984
Practice Address - Country:US
Practice Address - Phone:787-769-4520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR22305207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program