Provider Demographics
NPI:1568345031
Name:OLEAGA LOPEZ, CRISTIAN JOSE (PA)
Entity type:Individual
Prefix:DR
First Name:CRISTIAN
Middle Name:JOSE
Last Name:OLEAGA LOPEZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 66 BOX 7238
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-9269
Mailing Address - Country:US
Mailing Address - Phone:787-988-5965
Mailing Address - Fax:
Practice Address - Street 1:PR-984 # 163 BARRIO NARANJO
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-2710
Practice Address - Country:US
Practice Address - Phone:787-988-5965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2614363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical