Provider Demographics
NPI:1366914350
Name:LOPEZ-CEPERO, GERARDO JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:JOSE
Last Name:LOPEZ-CEPERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE MUNOZ RIVERA #3
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-0000
Mailing Address - Country:US
Mailing Address - Phone:787-883-0124
Mailing Address - Fax:787-883-0222
Practice Address - Street 1:CALLE MUNOZ RIVERA #3
Practice Address - Street 2:
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692-0000
Practice Address - Country:US
Practice Address - Phone:787-883-0124
Practice Address - Fax:787-883-0222
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21713208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice