Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 3198 | PR |
N | 111NI0900X | Internist | 3198 | PR |
Y | 207RA0201X | Internist - Allergy & Immunology | 3198 | PR |
NPI | 1043293848 |
---|---|
Provider Name | Carlos Eugenio Lopez Almodovar |
First Address | San Juan, PR 00936-3095 |
Second Address | San Juan, PR 00921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2005 |
Last Update Date | 05/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7910084 | HUMANA INS (01) | PR |
94756 | TRIPLE S (01) | PR |
C83873 | (02) |