Provider Demographics
NPI:1912113424
Name:LOPEZ-ERQUICIA, MARIA T (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:T
Last Name:LOPEZ-ERQUICIA
Suffix:
Gender:F
Credentials:MD, MPH
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 1133
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-1133
Mailing Address - Country:US
Mailing Address - Phone:787-896-3659
Mailing Address - Fax:
Practice Address - Street 1:17 CALLE BETANCES
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2317
Practice Address - Country:US
Practice Address - Phone:787-896-3659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11237208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR11237OtherLICENSE