| Doctor Name: | MRS. EVANGELISTA DEL CARMEN JUSINO LOPEZ |
| NPI Number: | 1689897357 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 8591 |
| Business Practice Address: | Calle 12 # 21 Urb Las Mercedes Salinas, PR - 00751 |
| Business Phone Number: | 7878242662 |
| Business Fax Number: | |
| Mailing Address: | Po Box 41, Calle 12 # 21 Urb Las Mercedes SALINAS |
| State: | PR |
| Postal Code: | 00751 |
| Phone Number: | 7878242662 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 8591 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |