Provider Demographics
NPI:1619928108
Name:LOPEZ NEGRON, MERLYN (OTL, MPH, CHT)
Entity Type:Individual
Prefix:MRS
First Name:MERLYN
Middle Name:
Last Name:LOPEZ NEGRON
Suffix:
Gender:F
Credentials:OTL, MPH, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30226
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-1226
Mailing Address - Country:US
Mailing Address - Phone:787-999-5538
Mailing Address - Fax:787-999-5539
Practice Address - Street 1:1260 CALLE 54 SE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3143
Practice Address - Country:US
Practice Address - Phone:787-999-5538
Practice Address - Fax:787-999-5539
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR916225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRQ06678Medicare UPIN
PR0068132Medicare PIN