Basic Information
| Provider Information | |||||||||
| NPI: | 1497740849 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOPEZ HERNANDEZ | ||||||||
| FirstName: | RAFAEL | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 363682 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009363682 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876168226 | ||||||||
| FaxNumber: | 7875351057 | ||||||||
| Practice Location | |||||||||
| Address1: | AVE JUAN PONCE DE LEON | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877582000 | ||||||||
| FaxNumber: | 7877534757 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2005 | ||||||||
| LastUpdateDate: | 06/09/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | ME131587 | FL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 11039 | PR | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.