Doctor Name: | DR. JAIME PEDRO LOPEZ-REVEROL |
NPI Number: | 1386645182 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 6830 |
Business Practice Address: | Inst San Pablo Santa Cruz St.#66 Suite 306 Bayamon, PR - 009617041 |
Business Phone Number: | 7877862690 |
Business Fax Number: | 7877875413 |
Mailing Address: | Inst San Pablo, Suite 306 BAYAMON |
State: | PR |
Postal Code: | 009617041 |
Phone Number: | 7877862690 |
Fax Number: | 7877875413 |
NPI Enumeration Date: | 08/03/2005 |
NPI Last Update Date: | 12/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 6830 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |