Organization
AMANECER MUTUO, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE A LOPEZ-CALERO DMD (PRESIDENT)
(787) 453-0563
Entity
Organization
Contact information
Practice address
5725 BLVD. MEDIA LUNA, SUITE # 5, GALERIAS DE ESCORIAL SHOPPING CENTER, CAROLINA, PR 00987
(787) 453-0563
Mailing address
PO BOX 1893, CAROLINA, PR 00984-1893
(787) 453-0563
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
2751
PR
208D00000X
General Practice Physician
16005
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BX187A
MEDICARE PTAN
PR
Enumeration date
05/19/2010
Last updated
05/19/2010
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