| Doctor Name: | DR. TOMAS JORDAN LOPEZ |
| NPI Number: | 1447288972 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 5701 |
| Business Practice Address: | Ave Main Bldg 51 #39 Santa Rosa Bayamon, PR - 00959 |
| Business Phone Number: | 7877985615 |
| Business Fax Number: | 7877401445 |
| Mailing Address: | Ave Main Bldg 51 #39 Santa Rosa, BAYAMON |
| State: | PR |
| Postal Code: | 00959 |
| Phone Number: | 7877985615 |
| Fax Number: | 7877401445 |
| NPI Enumeration Date: | 06/30/2006 |
| NPI Last Update Date: | 01/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5701 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |