Provider Demographics
NPI:1659086197
Name:LOPEZ MUNOZ, PEDRO ANTONIO
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:ANTONIO
Last Name:LOPEZ MUNOZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URBANIZACION ALTAMIRA BUZON 85
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669
Mailing Address - Country:US
Mailing Address - Phone:939-285-1774
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION MONTEBELLO
Practice Address - Street 2:CALLE 23 DE SEPT #97
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:939-285-1774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-19
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16475-I2083P0901X
PR23802208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine