Basic Information
| Provider Information | |||||||||
| NPI: | 1790074904 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAYO LOPEZ | ||||||||
| FirstName: | ERWIN | ||||||||
| MiddleName: | EDUARDO | ||||||||
| NamePrefix: | MR. | ||||||||
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| OtherLastName: | RAYO LOPEZ | ||||||||
| OtherFirstName: | ERWIN | ||||||||
| OtherMiddleName: | EDUARDO | ||||||||
| OtherNamePrefix: | MR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1177 CALLE 56 SE | ||||||||
| Address2: | REPARTO METROPOLITANO | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009212728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873639515 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | UNIVERSITY OF PUERTO RICO | ||||||||
| Address2: | UPR-MEDICAL SCIENCES CAMPUS | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009363185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877540101 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2011 | ||||||||
| LastUpdateDate: | 03/29/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 179-E | PR | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.