Provider Demographics
NPI:1871267104
Name:LOPEZ, ANGELIMAR
Entity Type:Individual
Prefix:MRS
First Name:ANGELIMAR
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PASEOS REALES 1
Mailing Address - Street 2:AVE. PRINCESA
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-5550
Mailing Address - Country:US
Mailing Address - Phone:787-472-1105
Mailing Address - Fax:
Practice Address - Street 1:58 CALLE COLOMER SANCHEZ
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-2846
Practice Address - Country:US
Practice Address - Phone:787-472-1105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist