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Individual

MR. IVAN LOPERENA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PROPIETARY

Contact information

Practice address
68 URB CRISTAL, BO CORRALES, AGUADILLA, PR 00603-6306
(787) 882-5915
Mailing address
68 URB CRISTAL, BO CORRALES, AGUADILLA, PR 00603-6306
(787) 882-5915

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1094
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1053383216
SAL;UD DORADA MEDICARE
PR
01
20458
PMC MEDICARE CHOICE
PR
01
20526
AMERICAN HEALTH
PR
01
31489
MEDICARE SELECTO
PR
05
31489
PR
01
6030092
HUMANA INSURANCE
PR
01
660561350
MCS REFORMA
PR
Enumeration date
05/12/2008
Last updated
05/12/2008
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