Provider Demographics
NPI:1871501767
Name:LOPEZ, ALBA N (MD)
Entity Type:Individual
Prefix:MRS
First Name:ALBA
Middle Name:N
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:A-8 AVE LOPATEGUI URB PARKVILLE
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4452
Mailing Address - Country:US
Mailing Address - Phone:787-789-7252
Mailing Address - Fax:
Practice Address - Street 1:65 INFANTERY AVE BO SAN ANTON PARQUE IND ESCORIAL
Practice Address - Street 2:STATE INSURANCE FUND CFSE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-757-6850
Practice Address - Fax:787-776-2252
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR62722083X0100X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
F44018Medicare UPIN
PR27325Medicare ID - Type Unspecified