Provider Demographics
NPI:1376361485
Name:BAEZ LOPEZ, HECTOR
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:BAEZ LOPEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 193069
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-3069
Mailing Address - Country:US
Mailing Address - Phone:787-761-0036
Mailing Address - Fax:
Practice Address - Street 1:HOSP. HIMA CAGUAS, SUITE 401
Practice Address - Street 2:100 AVE LUIS MUNOZ MARIN
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-703-3688
Practice Address - Fax:877-494-2072
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1039231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist