Provider Demographics
NPI:1821139718
Name:LOPEZ, MARGARITA (ME)
Entity Type:Individual
Prefix:DR
First Name:MARGARITA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:ME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CALLE MARIO BRASCHI
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-2526
Mailing Address - Country:US
Mailing Address - Phone:787-825-1020
Mailing Address - Fax:
Practice Address - Street 1:18 CALLE MARIO BRASCHI
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-2526
Practice Address - Country:US
Practice Address - Phone:787-825-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11185208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics