Provider Demographics
NPI:1821047606
Name:LOPEZ, LUZ NEREIDA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUZ
Middle Name:NEREIDA
Last Name: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:LOPEZ BONET MEDICAL CLINIC
Mailing Address - Street 2:927 SANCHEZ VILELLA AVE., COUNTRY CLUB
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-3420
Mailing Address - Country:US
Mailing Address - Phone:787-757-6617
Mailing Address - Fax:787-757-6617
Practice Address - Street 1:LOPEZ BONET MEDICAL CLINIC
Practice Address - Street 2:927 SANCHEZ VILELLA AVE., COUNTRY CLUB
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-3420
Practice Address - Country:US
Practice Address - Phone:787-757-6617
Practice Address - Fax:787-757-6617
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9065208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR060275OtherCRUZ AZUL
PR011-8419OtherAACA
PR201577OtherPREFERRED HEALTH
PR81921OtherTRIPLES
PG2635OtherPALIC
PR660522569009240000OtherCHAMPUS
PR011-8419OtherAACA
PR81921Medicare ID - Type Unspecified