Provider Demographics
NPI:1821058504
Name:LOPEZ PEREZ, HECTOR FELIPE (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:FELIPE
Last Name:LOPEZ PEREZ
Suffix:
Gender:M
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 1
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0001
Mailing Address - Country:US
Mailing Address - Phone:787-816-8472
Mailing Address - Fax:787-816-8472
Practice Address - Street 1:55 CALLE MORELL CAMPOS
Practice Address - Street 2:URB. GARCIA
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4317
Practice Address - Country:US
Practice Address - Phone:787-816-8472
Practice Address - Fax:787-816-8472
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12219174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRHC04059Medicare UPIN
PR0089946Medicare ID - Type Unspecified