Provider Demographics
NPI:1457707622
Name:LOPEZ, JOSE A (EMT-P)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:A
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:EMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 4 BOX 18442
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-9517
Mailing Address - Country:US
Mailing Address - Phone:787-607-6845
Mailing Address - Fax:
Practice Address - Street 1:HC 4 BOX 18442
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-9517
Practice Address - Country:US
Practice Address - Phone:787-607-6845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2557-P146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic