Provider Demographics
NPI:1811626658
Name:LOPEZ AVILES, LUZ MARIA
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:MARIA
Last Name:LOPEZ AVILES
Suffix:
Gender:
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 355
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-0355
Mailing Address - Country:US
Mailing Address - Phone:787-240-3110
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA #2 KM 70.5
Practice Address - Street 2:BARRIO DOMINGO RUIZ
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-0000
Practice Address - Country:US
Practice Address - Phone:787-240-3110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR129141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical