Provider Demographics
NPI:1932964384
Name:BERNABE LOPEZ, JOSHUA NOMAR
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:NOMAR
Last Name:BERNABE 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 50176
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-0176
Mailing Address - Country:US
Mailing Address - Phone:787-219-7297
Mailing Address - Fax:
Practice Address - Street 1:AVE. LAUREL, SANTA JUANITA
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960-6032
Practice Address - Country:US
Practice Address - Phone:787-798-3001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program