Provider Demographics
NPI:1922443217
Name:ALVIRA LOPEZ, ALEXANDRA (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:ALVIRA LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:ALVIRA LOPEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:CAPARRA GALLERY PLAZA
Mailing Address - Street 2:107 CALLE ORTEGON SUITE 312
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-754-0907
Mailing Address - Fax:
Practice Address - Street 1:CAPARRA GALLERY PLAZA SUITE 312
Practice Address - Street 2:107 CALLE ORTEGON
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-754-0907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21071207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21071OtherALLOPATHIC AND OSTEOPATHIC PHYSICIANS/OBSTETRICS AND GYNECOLOGY