Provider Demographics
NPI:1184616336
Name:FUXENCH LOPEZ, ZELMA Z (MD)
Entity type:Individual
Prefix:
First Name:ZELMA
Middle Name:Z
Last Name:FUXENCH LOPEZ
Suffix:
Gender:F
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. BUCARE
Mailing Address - Street 2:#29 AMATISTA ST.
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-720-8113
Mailing Address - Fax:
Practice Address - Street 1:#66 SANTA CRUZ ST.
Practice Address - Street 2:INSTITUTO SAN PABLO - SUITE 409
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-787-5045
Practice Address - Fax:787-798-1690
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6566207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9-7860OtherTRIPLE S
PRD26671Medicare UPIN