Healthcare Provider Details

I. General information

NPI: 1144284845
Provider Name (Legal Business Name): JANET PIZAM ORTIZ MD PEDIATRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 10/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA CASTIGHONI K 5 BAYAMON GARDENS
BAYAMON PR
00957
US

IV. Provider business mailing address

CALLE 8 F 45 SANTA YENA
BAYAMON PR
00957
US

V. Phone/Fax

Practice location:
  • Phone: 787-730-3637
  • Fax: 787-730-3637
Mailing address:
  • Phone: 787-785-4047
  • Fax: 787-730-3637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number11596
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: