Provider Demographics
NPI:1013332154
Name:DR LOPEZ PINTO
Entity Type:Organization
Organization Name:DR LOPEZ PINTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACTURADORA
Authorized Official - Prefix:MR
Authorized Official - First Name:ILONKA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-460-3329
Mailing Address - Street 1:MGS BUILDING LOCAL 101
Mailing Address - Street 2:MARGINAL B19 URB FLAMBOYAN
Mailing Address - City:MANATI
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00674
Mailing Address - Country:UM
Mailing Address - Phone:787-460-3329
Mailing Address - Fax:
Practice Address - Street 1:MARGINAL B19 URB FLAMBOYAN
Practice Address - Street 2:MGS BUILDING LOCAL 101
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-460-3329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR684291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory