Provider Demographics
NPI:1902589617
Name:GONZALEZ LOPEZ, FE M
Entity Type:Individual
Prefix:
First Name:FE
Middle Name:M
Last Name:GONZALEZ LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1963 CALLE LOIZA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-1831
Mailing Address - Country:US
Mailing Address - Phone:787-728-0033
Mailing Address - Fax:
Practice Address - Street 1:1963 CALLE LOIZA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1831
Practice Address - Country:US
Practice Address - Phone:787-728-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician