Doctor Name: | DR. HECTOR LUIS LOPEZ-ORTIZ |
NPI Number: | 1386842342 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ACN 200 |
Business Practice Address: | 501 Gary Hill Rd Edgefield, SC - 298244503 |
Business Phone Number: | 8036371444 |
Business Fax Number: | |
Mailing Address: | 1092 Hampstead Pl, MARTINEZ |
State: | GA |
Postal Code: | 309076200 |
Phone Number: | 7875576225 |
Fax Number: | |
NPI Enumeration Date: | 07/10/2007 |
NPI Last Update Date: | 07/10/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ACN 200 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |