1891486031 NPI number — MISS MELANIE DEL ROSARIO LOPEZ MD

Table of content: MISS MELANIE DEL ROSARIO LOPEZ MD (NPI 1891486031)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891486031 NPI number — MISS MELANIE DEL ROSARIO LOPEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOPEZ
Provider First Name:
MELANIE
Provider Middle Name:
DEL ROSARIO
Provider Name Prefix Text:
MISS
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:
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:
1891486031
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
84 MACOPA STREET SANTA MESA HEIGHTS
Provider Second Line Business Mailing Address:
BARANGAY SANTO DOMINGO
Provider Business Mailing Address City Name:
QUEZON CITY
Provider Business Mailing Address State Name:
NATIONAL CAPITAL REGION
Provider Business Mailing Address Postal Code:
01114
Provider Business Mailing Address Country Code:
PH
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PHILIPPINE HEART CENTER
Provider Second Line Business Practice Location Address:
EAST AVENUE, DILIMAN
Provider Business Practice Location Address City Name:
QUEZON CITY
Provider Business Practice Location Address State Name:
NATIONAL CAPITAL REGION
Provider Business Practice Location Address Postal Code:
000850
Provider Business Practice Location Address Country Code:
PH
Provider Business Practice Location Address Telephone Number:
28-925-2401
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/18/2023

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: 2080P0202X , with the licence number:  0118158 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0203X , with the licence number: 48069 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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