Provider Demographics
NPI:1720373517
Name:LOPEZ, MAGDALY (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:MAGDALY
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 AVE RAFAEL CORDERO PMB 198
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-469-9296
Mailing Address - Fax:
Practice Address - Street 1:200 AVE RAFAEL CORDERO PMB 198
Practice Address - Street 2:SUITE 140
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-469-9296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist