| Doctor Name: | MIRIAM LOPEZ LOPEZ |
| NPI Number: | 1063779452 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 001455 |
| Business Practice Address: | Corporacion Del Fondo Del Seguro Del Estado Carr #3 65th Infanteria Sector Comunidad Escorial Carolina, PR - 00985 |
| Business Phone Number: | 7877576850 |
| Business Fax Number: | |
| Mailing Address: | Brisas De Loiza, Calle Sagitario #95 CANOVANAS |
| State: | PUERTO RICO |
| Postal Code: | 00729 |
| Phone Number: | 7874601970 |
| Fax Number: | |
| NPI Enumeration Date: | 04/23/2012 |
| NPI Last Update Date: | 04/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 183700000X |
| License Number: | 001455 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacy Technician |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |