Provider Demographics
NPI:1629038427
Name:ROMAN LOPEZ, MARIA M (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:M
Last Name:ROMAN 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:PO BOX 7289
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7289
Mailing Address - Country:US
Mailing Address - Phone:787-746-2880
Mailing Address - Fax:787-746-9172
Practice Address - Street 1:AVE DEGETAU # F7
Practice Address - Street 2:BONNEVILLE TERRACE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5819
Practice Address - Country:US
Practice Address - Phone:787-746-2880
Practice Address - Fax:787-746-9172
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6351207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6351OtherLICENCIA
PR6351OtherLICENCIA