Individual
JUAN LOPEZ TIBONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6130
(215) 327-6202
Mailing address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6192
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD487427
PA
Other
Enumeration date
07/20/2021
Last updated
06/02/2025
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