Provider Demographics
NPI:1043049703
Name:RODRIGUEZ-LOPEZ, MARLANE (MD)
Entity type:Individual
Prefix:
First Name:MARLANE
Middle Name:
Last Name:RODRIGUEZ-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 1:223 CALLE UROGALLO
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9685
Mailing Address - Country:US
Mailing Address - Phone:262-309-4308
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 129, KM 1.0 AV. SAN LUIS
Practice Address - Street 2:
Practice Address - City:ARE
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-650-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24064208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice