Provider Demographics
NPI:1245253178
Name:LOPEZ-GARCIA, JOSEFINA M (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEFINA
Middle Name:M
Last Name:LOPEZ-GARCIA
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 1:618 CALLE AUSTRAL
Mailing Address - Street 2:ALTAMIRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-4239
Mailing Address - Country:US
Mailing Address - Phone:787-409-5828
Mailing Address - Fax:787-999-1723
Practice Address - Street 1:618 CALLE AUSTRAL
Practice Address - Street 2:ALTAMIRA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4239
Practice Address - Country:US
Practice Address - Phone:787-409-5828
Practice Address - Fax:787-999-1723
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7561208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7561OtherMD LICENSE