Provider Demographics
NPI:1609282284
Name:LOPEZ, MARIA (REGISTER NURSE)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:REGISTER NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE SANTIAGO IGLESIAS PANTIN
Mailing Address - Street 2:#400 BDA OBRERA
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:US
Mailing Address - Phone:787-598-1057
Mailing Address - Fax:
Practice Address - Street 1:CALLE SANTIAGO IGLESIAS PANTIN
Practice Address - Street 2:#400 BDA OBRERA
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-598-1057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR37236163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse