1922082445 NPI number — DR. LIONEL FERNANDEZ-LOPEZ MD

Table of content: DR. LIONEL FERNANDEZ-LOPEZ MD (NPI 1922082445)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922082445 NPI number — DR. LIONEL FERNANDEZ-LOPEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERNANDEZ-LOPEZ
Provider First Name:
LIONEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922082445
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB. LA COLINA
Provider Second Line Business Mailing Address:
STREET B #29
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969-3261
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-720-5222
Provider Business Mailing Address Fax Number:
787-789-7604

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 CALLE CRISALIDA
Provider Second Line Business Practice Location Address:
URB. MUNOZ RIVERA
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00969-3609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-720-5238
Provider Business Practice Location Address Fax Number:
787-272-0824
Provider Enumeration Date:
11/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  7851 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7851 . This is a "P.R. MEDICAL LICENSE #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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