Provider Demographics
NPI:1871624783
Name:LOPEZ, CARMEN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 CALLE MIRTO
Mailing Address - Street 2:MONTE CASINO
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-3707
Mailing Address - Country:US
Mailing Address - Phone:787-948-3069
Mailing Address - Fax:
Practice Address - Street 1:364 CALLE MIRTO
Practice Address - Street 2:MONTE CASINO
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-3707
Practice Address - Country:US
Practice Address - Phone:787-948-3069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15889208000000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine