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Individual

JUAN CARLOS LOPEZ DE VICTORIA-RIVERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
AVE LUIS MUNOZ RIVERA A-1 #402, CENTRO DE CIRUGIA AMBULATORIA HIMA/SAN PABLO CAGUAS, CAGUAS, PR 00725-4980
(787) 372-4022
Mailing address
PO BOX 4960, PMB #381, CAGUAS, PR 00726-4960
(787) 372-4022

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
016783
PR
208600000X
Surgery Physician
036-113950
IL
208600000X
Surgery Physician
MD429473
PA

Other

Enumeration date
08/31/2006
Last updated
11/04/2010
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