Individual
MARIANO OLMO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
BF1 CALLE 22, VILLA UNIVERSITARIA, HUMACAO, PR 00791-4339
(787) 217-4858
Mailing address
BF1 CALLE 22, VILLA UNIVERSITARIA, HUMACAO, PR 00791-4339
(787) 217-4858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18950
PR
Other
Enumeration date
11/20/2014
Last updated
02/21/2020
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