Provider Demographics
NPI:1215058474
Name:LOPEZ, LEOCADIA (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:LEOCADIA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 CAMINO ALEJANDRINO CONDOMINO PARQUE SAN RAMON
Mailing Address - Street 2:APT 701
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-287-0276
Mailing Address - Fax:787-767-6600
Practice Address - Street 1:BASTAMANTE 550
Practice Address - Street 2:SERGIO CUEVAS
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-763-5560
Practice Address - Fax:787-767-6600
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9764163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse