Provider Demographics
NPI:1952803942
Name:LOPEZ DELGADO, JUAN E
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:E
Last Name:LOPEZ DELGADO
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:HC 5 BOX 91500
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9516
Mailing Address - Country:US
Mailing Address - Phone:787-563-0124
Mailing Address - Fax:
Practice Address - Street 1:BO HATO ABAJO SECTOR BARRANCA
Practice Address - Street 2:CARR 653 KM 2.5
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-9516
Practice Address - Country:US
Practice Address - Phone:787-563-0124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty