Individual
MR. SERGIO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
COND TABAIBA GDNS, AVE HUNGRIA # 276, PONCE, PR 00716-1384
(787) 842-6682
Mailing address
5220 CALLE LORENCITA FERRER, EL TUQUE, PONCE, PR 00728-4832
(787) 219-9207
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
4761CP
PR
Other
Enumeration date
12/13/2010
Last updated
12/13/2010
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