Provider Demographics
NPI:1427253145
Name:PEREZ-LOPEZ, CARLOS JAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:JAVIER
Last Name:PEREZ-LOPEZ
Suffix:
Gender:M
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:PO BOX 1508
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1508
Mailing Address - Country:US
Mailing Address - Phone:787-464-2788
Mailing Address - Fax:787-831-1011
Practice Address - Street 1:SECTOR LA LOMA AVE HOSTOS KM 154
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682
Practice Address - Country:US
Practice Address - Phone:787-464-2788
Practice Address - Fax:787-831-1011
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17246207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery