1922443217 NPI number — ALEXANDRA ALVIRA LOPEZ MD

Table of content: ALEXANDRA ALVIRA LOPEZ MD (NPI 1922443217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922443217 NPI number — ALEXANDRA ALVIRA LOPEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALVIRA LOPEZ
Provider First Name:
ALEXANDRA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALVIRA LOPEZ
Provider Other First Name:
ALEXANDRA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1922443217
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CAPARRA GALLERY PLAZA
Provider Second Line Business Mailing Address:
107 CALLE ORTEGON SUITE 312
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00966
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-754-0907
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CAPARRA GALLERY PLAZA SUITE 312
Provider Second Line Business Practice Location Address:
107 CALLE ORTEGON
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00966
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-754-0907
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/01/2013

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: 207V00000X , with the licence number:  21071 , 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: 21071 . This is a "ALLOPATHIC AND OSTEOPATHIC PHYSICIANS/OBSTETRICS AND GYNECOLOGY" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".