Basic Information
| Provider Information | |||||||||
| NPI: | 1285129791 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | LOPEZ MARTE | ||||||||
| FirstName: | PAOLA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY HOSPITAL 4TH FLOOR | ||||||||
| Address2: | GASTROENTEROLOGY RESEARCH UNIT | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877540101 | ||||||||
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| Practice Location | |||||||||
| Address1: | UNIVERSITY HOSPITAL 4TH FLOOR | ||||||||
| Address2: | GASTROENTEROLOGY RESEARCH UNIT | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877540101 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2018 | ||||||||
| LastUpdateDate: | 09/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 33453R | PR | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 22227 | PR | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.