Provider Demographics
NPI:1487889838
Name:LOPEZ, HARRY NELSON (EMT)
Entity type:Individual
Prefix:MR
First Name:HARRY
Middle Name:NELSON
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4003
Mailing Address - Street 2:PMB 129
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-8009
Mailing Address - Country:US
Mailing Address - Phone:787-431-2413
Mailing Address - Fax:787-818-0033
Practice Address - Street 1:CALLE BLANCA E. CHICO
Practice Address - Street 2:BO PUEBLO SECTOR EL BAMBU
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-431-2413
Practice Address - Fax:787-818-0033
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1668146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic