Provider Demographics
NPI:1801189394
Name:LOPEZ, MARIA LUISA (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LUISA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 187 CALLE DALIA
Mailing Address - Street 2:WALGREENS 12657
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-791-9764
Mailing Address - Fax:787-791-3577
Practice Address - Street 1:CARR 187 CALLE DALIA
Practice Address - Street 2:WALGREENS 12657
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-0000
Practice Address - Country:US
Practice Address - Phone:787-791-9764
Practice Address - Fax:787-791-3577
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2990183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist