Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 17148 | PR |
NPI | 1013175850 |
---|---|
Provider Name | Dr. Jose A Lopez Torres |
First Address | Guayanilla, PR 00656-0239 |
Second Address | Guayanilla, PR 00656-1743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 02/12/2020 |