Provider Demographics
NPI:1649363581
Name:LOPEZ ACOSTA, RAMON LUIS (MD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:LUIS
Last Name:LOPEZ ACOSTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 367386
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-7386
Mailing Address - Country:US
Mailing Address - Phone:787-725-7888
Mailing Address - Fax:787-995-7405
Practice Address - Street 1:650 CALLE LLOVERAS STE 207
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2114
Practice Address - Country:US
Practice Address - Phone:787-728-7888
Practice Address - Fax:787-995-7405
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR09645207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRFL3879155OtherDEA