Provider Demographics
NPI:1124759600
Name:BAEZ LOPEZ, LUZ MARGARITA (MD)
Entity type:Individual
Prefix:DR
First Name:LUZ
Middle Name:MARGARITA
Last Name:BAEZ LOPEZ
Suffix:
Gender:
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:CALLE GLADIOLA 6866
Mailing Address - Street 2:SABANA SECA
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00952
Mailing Address - Country:US
Mailing Address - Phone:787-367-1119
Mailing Address - Fax:
Practice Address - Street 1:AVE TENIENTE CESAR GONZALEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919-3044
Practice Address - Country:US
Practice Address - Phone:787-200-7841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR024305208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1087-P.A.OtherP.A.