Provider Demographics
NPI:1033926357
Name:LOPEZ, ROBERTO JOSE
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:JOSE
Last Name:LOPEZ
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 1:1905 OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-1613
Mailing Address - Country:US
Mailing Address - Phone:303-210-7829
Mailing Address - Fax:
Practice Address - Street 1:10355 E ILIFF AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80247-3622
Practice Address - Country:US
Practice Address - Phone:303-755-4955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter