Provider Demographics
NPI:1023119831
Name:ARCE-LOPEZ, EMILIO A (MD)
Entity type:Individual
Prefix:
First Name:EMILIO
Middle Name:A
Last Name:ARCE-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 1:150 AVE DE DIEGO
Mailing Address - Street 2:SUITE 502
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-2300
Mailing Address - Country:US
Mailing Address - Phone:787-721-2142
Mailing Address - Fax:787-721-1882
Practice Address - Street 1:150 AVE DE DIEGO
Practice Address - Street 2:SUITE 502
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-2300
Practice Address - Country:US
Practice Address - Phone:787-721-2142
Practice Address - Fax:787-721-1882
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9170207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF39763Medicare UPIN
PR0083078Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID