Provider Demographics
NPI:1780679282
Name:GARCIA - LOPEZ, LUIS F (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:F
Last Name:GARCIA - LOPEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LUIS
Other - Middle Name:
Other - Last Name:GARCIA - LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 270246
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928
Mailing Address - Country:US
Mailing Address - Phone:787-763-5541
Mailing Address - Fax:787-751-8894
Practice Address - Street 1:12 CALLE BARBOSA N
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-3730
Practice Address - Country:US
Practice Address - Phone:787-738-6990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5715208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR600256OtherMMMHC
PR065549OtherLA CRUZ AZUL DE PR
PR9260023OtherHUMANA PR
PR2500922OtherACAA
PR25406GAOtherSSS
PR9260023OtherHUMANA PR
PRC77648Medicare UPIN