| Doctor Name: | JORGE LOPEZ |
| NPI Number: | 1144309600 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 14939 |
| Business Practice Address: | Ave. Luis Munoz Marin X-14 Mariolga Caguas, PR - 00725 |
| Business Phone Number: | 7877432067 |
| Business Fax Number: | 7877432067 |
| Mailing Address: | E20 Calle Tabonuco, Arbolada CAGUAS |
| State: | PR |
| Postal Code: | 007271306 |
| Phone Number: | 9393972065 |
| Fax Number: | 7877432067 |
| NPI Enumeration Date: | 11/03/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 14939 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |