Provider Demographics
NPI:1922082445
Name:FERNANDEZ-LOPEZ, LIONEL (MD)
Entity Type:Individual
Prefix:DR
First Name:LIONEL
Middle Name:
Last Name:FERNANDEZ-LOPEZ
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:URB. LA COLINA
Mailing Address - Street 2:STREET B #29
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3261
Mailing Address - Country:US
Mailing Address - Phone:787-720-5222
Mailing Address - Fax:787-789-7604
Practice Address - Street 1:5 CALLE CRISALIDA
Practice Address - Street 2:URB. MUNOZ RIVERA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3609
Practice Address - Country:US
Practice Address - Phone:787-720-5238
Practice Address - Fax:787-272-0824
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7851207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7851OtherP.R. MEDICAL LICENSE #