# GES CDT DR JOSE A LOPEZ ANTONGIORGI

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508997479
- **Authorized official:** RAUL VILLALOBOS MD (PRESIDENT)
- **Authorized official phone:** (787) 767-8758

## Contact information

- **Practice address:** 25 CALLE NE 333, PUERTO NUEVO, SAN JUAN, PR 00920
- **Practice address phone:** (787) 793-8989
- **Mailing address:** PO BOX 193044, SAN JUAN, PR 00919-3044
- **Mailing address phone:** (787) 767-8758

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 08F2460 | PR | Yes |

## Other

- **Enumeration date:** 03/09/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | NCPDP4023103 | PHARMACY | PR |