Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 21823 | PR |
NPI | 1255771150 |
---|---|
Provider Name | Coral Lopez |
First Address | San Juan, PR 00935-0001 |
Second Address | Caguas, PR 00775 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2013 |
Last Update Date | 08/07/2021 |