Provider Demographics
NPI:1982814505
Name:LOPEZ, SARI M (ATOR)
Entity Type:Individual
Prefix:MRS
First Name:SARI
Middle Name:M
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:ATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE ZENON VAZQUEZ
Mailing Address - Street 2:BUZON RES. # 5
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0005
Mailing Address - Country:US
Mailing Address - Phone:787-223-5089
Mailing Address - Fax:
Practice Address - Street 1:AQUQMARINA # 66
Practice Address - Street 2:URB. VILLA BLANCA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-743-3385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR522224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant