Healthcare Provider Details

I. General information

NPI: 1689888984
Provider Name (Legal Business Name): CESAR A. ORTIZ-SORRENTINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

INSTITUTO SAN PABLO, SUITE 309 SANTA CRUZ #67
BAYAMON PR
00960
US

IV. Provider business mailing address

CONDOMINIO ASTRALIS 9550 CALLE DIAZ WAY, APT.. 519
CAROLINA PR
00979-1424
US

V. Phone/Fax

Practice location:
  • Phone: 787-755-3114
  • Fax:
Mailing address:
  • Phone: 787-755-3114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5350
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: