Provider Demographics
NPI:1023302452
Name:RUTZEN-LOPEZ, ISABEL MARIA
Entity type:Individual
Prefix:DR
First Name:ISABEL
Middle Name:MARIA
Last Name:RUTZEN-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:CONDOMINIO SANTA MARIA
Mailing Address - Street 2:139 CARR 177 APT 802
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5351
Mailing Address - Country:US
Mailing Address - Phone:787-365-8596
Mailing Address - Fax:787-785-7277
Practice Address - Street 1:CENTRO MEDICO
Practice Address - Street 2:BO MONACILLOS AVE AMERICO MIRANDA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-763-4149
Practice Address - Fax:787-999-4048
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR018954208100000X
PR18954208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty