| Consultorio Dra Idalia Pedroza Lopez Llc | |
|
201 Gautier Benitez Avenue Consolidated Medical Plaza, Suite 201 Caguas PR 00725 | |
| (787) 743-1699 | |
| (787) 258-1517 |
| Full Name | Consultorio Dra Idalia Pedroza Lopez Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 201 Gautier Benitez Avenue, Caguas, Puerto Rico |
| Authorized Official Name and Position | Idalia Pedroza Lopez (PRESIDENT OF THE ORGANIZATION) |
| Authorized Official Contact | 7877431699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Consultorio Dra Idalia Pedroza Lopez Llc Po Box 6735 Caguas PR 00726-6735 Ph: (787) 743-1699 | Consultorio Dra Idalia Pedroza Lopez Llc 201 Gautier Benitez Avenue Consolidated Medical Plaza, Suite 201 Caguas PR 00725 Ph: (787) 743-1699 |
| NPI Number | 1912684184 |
|---|---|
| Provider Enumeration Date | 06/29/2023 |
| Last Update Date | 06/29/2023 |
| Medicare PECOS PAC ID | 5890142038 |
|---|---|
| Medicare Enrollment ID | O20231109003134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912684184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Idalia Pedroza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477687564 PECOS PAC ID: 2860556206 Enrollment ID: I20090129000141 |
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