Individual
MR. JOSE ENRIQUE LOPEZ RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN/RN
Contact information
Practice address
CONSOLIDATED MALL B5, 202 AVE GAUTIER BENITEZ, CAGUAS, PR 00726-0000
(787) 704-0705
Mailing address
PO BOX 370814, CAYEY, PR 00737-0814
(787) 557-0478
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
86976
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0080025105659
—
PR
Enumeration date
08/08/2018
Last updated
08/08/2018
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