Provider Demographics
NPI:1528140472
Name:LOPEZ MORALES, ANGEL (MD)
Entity type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:
Last Name:LOPEZ MORALES
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:CALLE # 70 BLOQUE 87 # 10
Mailing Address - Street 2:ALTOS DE LA SIERRA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:939-940-1741
Mailing Address - Fax:
Practice Address - Street 1:87-10 CALLE 70
Practice Address - Street 2:ALTOS DE LA SIERRA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4571
Practice Address - Country:US
Practice Address - Phone:939-940-1741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7974208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice