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DR. OCTAVIO JORDAN LOPEZ M.D. NPI 1760475024


NPI Information

NPI: 1760475024
Provider Name: DR. OCTAVIO JORDAN LOPEZ, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 40D0951327

Address:
EDIF MEDICO SANTA CRUZ
SUITE 313
BAYAMON, PR
ZIP 00961
Phone: (787) 780-7832
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DR. Octavio Jordan Lopez, M.D. is a specialist in Bayamon, PR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Octavio Jordan Lopez, M.D. NPI is 1760475024. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

EDIF MEDICO SANTA CRUZ
SUITE 313
BAYAMON, PR
ZIP 00961-910
Phone: (787) 780-7832
Fax: (787) 798-1445

The NPI 1760475024 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 40D0951327 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/23/2005 and was last updated on 5/20/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist3658PUERTO RICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D32934MEDICARE UPINPUERTO RICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.