Provider Demographics
NPI:1124068820
Name:LOPEZ, ROSA MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:ROSA
Middle Name:MARIA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 CALLE BARCELONA
Mailing Address - Street 2:BARCELONA COURT APT 206
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-2760
Mailing Address - Country:US
Mailing Address - Phone:787-433-1384
Mailing Address - Fax:
Practice Address - Street 1:113 CALLE BARCELONA
Practice Address - Street 2:BARCELONA COURT APT 206
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-2760
Practice Address - Country:US
Practice Address - Phone:787-433-1384
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15814208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice