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Individual

DR. EDWIN BANNACEK LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
CALLE FRANCISCO G BRUNO #48 OESTE ESQUINA SAN ANTONIO, GUAYAMA, PR 00784-0078
(787) 409-6657
(787) 409-6657
Mailing address
PO BOX 13, GUAYAMA, PR 00785-0013
(787) 409-6657

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
19831
PR

Other

Enumeration date
01/29/2018
Last updated
12/27/2022
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